Individual
DR. JUAN ISRAEL MEDINA JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S. M.S.
Contact information
Practice address
PONCE DE LEON #735 TORRE MEDICO DENTAL AUXILIO MUTUO, SUITE #607, SAN JUAN, PR 00917-5028
(787) 767-7850
Mailing address
TORRE MEDICO DENTAL AUXILIO MUTUO, SUITE #607 PONCE DE LEON #735, SAN JUAN, PR 00917-5028
(787) 767-7850
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
2076
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041823
CRUZ AZUL
—
01
—
206674
UTI
PR
01
—
42135ME
SSS
PR
01
—
9690066
HUMANA
PR
Enumeration date
02/10/2006
Last updated
07/08/2007
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