Organization
PEDIATRIC & GENERAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN C CARRASQUILLO QUINONES MD (PRESIDENT)
(787) 314-2325
Entity
Organization
Contact information
Practice address
410 AVE HOSTOS STE 123, MAYAGUEZ, PR 00682-1560
(787) 314-2325
Mailing address
PO BOX 1605, RINCON, PR 00677-1605
(787) 314-2325
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0120X
Pediatric Surgery Physician
—
—
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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