# GRUPO MEDICO JATIBONICO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013408459
- **Authorized official:** MR. JOAQUIN A FELICIANO SR. (ADMINISTRATOR)
- **Authorized official phone:** (787) 625-2500

## Contact information

- **Practice address:** 65 CALLE PEDRO ROSARIO, AIBONITO, PR 00705-3237
- **Practice address phone:** (787) 625-2500
- **Practice address fax:** (787) 625-0438
- **Mailing address:** URB. CARIBE 1551, CALLE ALDA, SAN JUAN, PR 00926
- **Mailing address phone:** (787) 625-2500
- **Mailing address fax:** (787) 625-0438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | PR | Yes |

## Other

- **Enumeration date:** 05/22/2018
- **Last updated:** 05/22/2018