MEDICARE: DR. JOSE R MEDRANO PEREZ III MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	19853	PR
2	207Q00000X	Family Medicine Physician	19853	PR

General Provider Information

NPI Number	:	1952817645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE R MEDRANO PEREZ III MD

Provider Business Mailing Address
First Line	:	I23 CALLE 1
Second Line	:	ESTANCIAS DE SAN FERNANDO
City	:	CAROLINA
State	:	PR
Zip	:	00985
Country	:	US
Telephone Number	:	787-225-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR 349 KM 2.7 CERRO LAS MESAS
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-8321
Country	:	US
Telephone Number	:	787-834-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	08/19/2025

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