Provider Demographics
NPI:1023575768
Name:JEO LLC
Entity Type:Organization
Organization Name:JEO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ECHENIQUE ARANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-708-6456
Mailing Address - Street 1:26 CALLE BELEN
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3123
Mailing Address - Country:US
Mailing Address - Phone:787-708-6456
Mailing Address - Fax:
Practice Address - Street 1:735 AVE PONCE DE LEON STE 201
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5023
Practice Address - Country:US
Practice Address - Phone:787-771-1000
Practice Address - Fax:787-771-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty