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Organization

JDDM INC

Active
Other names
New Balance Puerto Rico
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSE C RODRIGUEZ-PORTELA DPM (SECRETARY)
(787) 344-3553
Entity
Organization

Contact information

Practice address
210 AVE CARLOS CHARDON STE 104, SAN JUAN, PR 00918-1716
(787) 756-2121
Mailing address
210 AVE CARLOS CHARDON STE 104, SAN JUAN, PR 00918-1716
(787) 756-2121

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
103
PR

Other

Enumeration date
01/26/2013
Last updated
01/26/2013
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