# PEDIATRIC PRO & MEDICINE LLC

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

## Provider details

- **NPI number:** 1295223055
- **Authorized official:** MR. JORGE E DEL VALLE PE (ADMINISTRATOR)
- **Authorized official phone:** (787) 924-7575

## Contact information

- **Practice address:** CALLE JOSE C VAZQUEZ CARRETERA 726, URB VLLA ROSALES, AIBONITO, PR 00705
- **Practice address phone:** (787) 735-8100
- **Practice address fax:** (787) 924-7575
- **Mailing address:** PO BOX 8549, CAGUAS, PR 00726-8549
- **Mailing address phone:** (787) 924-7575
- **Mailing address fax:** (787) 924-7575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 207PP0204X | Pediatric Emergency Medicine (Emergency Medicine) Physician | — | NULL | — |
| 207PP0204X | Pediatric Emergency Medicine (Emergency Medicine) Physician | — | — | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | NULL | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | — | — |

## Other

- **Enumeration date:** 04/27/2018
- **Last updated:** 04/27/2018