Organization
MAYAGUEZ SURGICAL JUSTINIANO SURIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE JUSTINIANO M.D. (GENERAL PARTNER)
(787) 833-0868
Entity
Organization
Contact information
Practice address
MENDEZ VIGO 109 ESTE, MAYAGUEZ, PR 00680
(787) 834-7740
(787) 833-0868
Mailing address
PO BOX 3049, MAYAGUEZ, PR 00681-3049
(787) 833-5613
(787) 833-0868
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
7142
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144438649
NPI
PR
Enumeration date
11/16/2010
Last updated
10/31/2011
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