Ijac | |
6 Calle Socorro Quebradillas PR 00678 | |
(787) 895-3684 | |
Not Available |
Full Name | Ijac |
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Speciality | General Practice |
Location | 6 Calle Socorro, Quebradillas, Puerto Rico |
Authorized Official Name and Position | Jose Antonio Carrero Soto (MD) |
Authorized Official Contact | 7878953684 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ijac B2 Calle 1 Vistas De Camuy Camuy PR 00627-2904 Ph: (787) 895-3684 | Ijac 6 Calle Socorro Quebradillas PR 00678 Ph: (787) 895-3684 |
NPI Number | 1013455690 |
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Provider Enumeration Date | 02/03/2017 |
Last Update Date | 02/03/2017 |
Medicare PECOS PAC ID | 9638536600 |
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Medicare Enrollment ID | O20230606003207 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013455690 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 13155 (Puerto Rico) | Primary |
Provider Name | Jose Antonio Carrero |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1184837635 PECOS PAC ID: 6406151984 Enrollment ID: I20160222000519 |
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