# JACAGUAX MEDICAL CENTER

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

## Provider details

- **NPI number:** 1588798862
- **Authorized official:** DR. CARLOS ENRIQUE DOMINGUEZ MD (MEDICO DE FAMILIA)
- **Authorized official phone:** (787) 837-2923

## Contact information

- **Practice address:** CALLE LAS FLORES 168 A, JUANA DIAZ, PR 00795
- **Practice address phone:** (787) 837-2923
- **Practice address fax:** (787) 260-2921
- **Mailing address:** APARTADO 1418, JUANA DIAZ, PR 00795
- **Mailing address phone:** (787) 837-2923
- **Mailing address fax:** (787) 260-2921

## Taxonomy

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

## Other

- **Enumeration date:** 03/16/2007
- **Last updated:** 08/22/2020