Organization
MEDIPREV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILLIAM JORGE (PRESIDENT)
(787) 412-3346
Entity
Organization
Contact information
Practice address
CENTRO COMERCIAL CIUDAD JARDIN, LOCAL 1, BAYAMON, PR 00956
(787) 412-3346
Mailing address
DG15 CALLE BABILONIA, BAYAMON, PR 00956-5342
(787) 797-9999
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431130
BUSINESS REGISTER
PR
Enumeration date
10/18/2022
Last updated
10/18/2022
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