Organization
JC FAST CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE CEDENO ESPAILLAT MD (OWNER)
(787) 784-2218
Entity
Organization
Contact information
Practice address
610 AVE COMERIO FINAL, SUP ECONO LEVITTOWN, TOA BAJA, PR 00949
(787) 784-2218
(787) 784-3444
Mailing address
ME10 URB MARINA BAHIA, PLAZA 20, CATANO, PR 00962
(787) 518-2393
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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