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Individual

MR. EDMUNDO JUSINO SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
BALDORIOTY 18-4, YAUCO, PR 00698
(787) 267-6017
(787) 267-6017
Mailing address
PO BOX 1147, YAUCO, PR 00698
(787) 267-6017
(787) 267-6017

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
6812
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200006
MMM
01
2979
PMC
PR
01
2979
PMC
01
5062
AHMPR
PR
01
7680045
HUMANA
PR
01
8913
IMC
PR
Enumeration date
03/17/2006
Last updated
04/21/2009
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