Individual
JOSE A MAIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS MT
Contact information
Practice address
CARRETERA # 1 KM. 114.5 CINTRONA, JUANA DIAZ, PR 00795-9614
(787) 837-7600
(787) 837-7600
Mailing address
HC 02 BOX 10001, JUANA DIAZ, PR 00795-9614
(787) 837-7600
(787) 837-7600
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1193
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C722
INTERNATIONAL MEDICAL CARD
PR
Enumeration date
10/08/2009
Last updated
10/08/2009
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