# MEDI EX CSP

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

## Provider details

- **NPI number:** 1992030431
- **Authorized official:** DR. JUAN ANDUJAR 7876460202 (DOCTOR)
- **Authorized official phone:** (787) 646-0202

## Contact information

- **Practice address:** ARZUAGA 112, SUITE 605, SAN JUAN, PR 00925-3316
- **Practice address phone:** (787) 646-0202
- **Practice address fax:** (787) 763-0200
- **Mailing address:** ARZUAGA 112, SUITE 605, SAN JUAN, PR 00925-3316
- **Mailing address phone:** (787) 646-0202
- **Mailing address fax:** (787) 763-0200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 10/15/2009
- **Last updated:** 10/15/2009