Individual
JUAN R MEDINA MORELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1008 AVE AMERICO MIRANDA, RIO PIEDRAS, PR 00921-2842
(829) 717-8822
Mailing address
PO BOX 79191, CAROLINA, PR 00984-9191
(829) 717-8822
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
15480-I
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/23/2019
Last updated
12/27/2021
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