| Jc Fast Clinic Llc | |
|
610 Ave Comerio Final Sup Econo Levittown Toa Baja PR 00949 | |
| (787) 784-2218 | |
| (787) 784-3444 |
| Full Name | Jc Fast Clinic Llc |
|---|---|
| Speciality | General Practice |
| Location | 610 Ave Comerio Final, Toa Baja, Puerto Rico |
| Authorized Official Name and Position | Jorge Cedeno Espaillat (OWNER) |
| Authorized Official Contact | 7877842218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jc Fast Clinic Llc Me10 Urb Marina Bahia Plaza 20 Catano PR 00962 Ph: (787) 518-2393 | Jc Fast Clinic Llc 610 Ave Comerio Final Sup Econo Levittown Toa Baja PR 00949 Ph: (787) 784-2218 |
| NPI Number | 1861051906 |
|---|---|
| Provider Enumeration Date | 06/12/2019 |
| Last Update Date | 06/12/2019 |
| Medicare PECOS PAC ID | 2961739669 |
|---|---|
| Medicare Enrollment ID | O20190802001686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861051906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jorge Cedeno Espaillat |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1316171168 PECOS PAC ID: 3678607033 Enrollment ID: I20100820000219 |
| Provider Name | Jose V Ramos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669815908 PECOS PAC ID: 7416181532 Enrollment ID: I20131003000364 |
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