Provider Demographics
NPI:1073839734
Name:JVLM MEDICOS CSP
Entity Type:Organization
Organization Name:JVLM MEDICOS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:FERRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:787-789-3790
Mailing Address - Street 1:A7 CALLE 2
Mailing Address - Street 2:MANSIONES DE GARDEN HILLS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2717
Mailing Address - Country:US
Mailing Address - Phone:787-789-3790
Mailing Address - Fax:787-789-3790
Practice Address - Street 1:9410 AVE LOS ROMEROS
Practice Address - Street 2:MONTEHIEDRA TOWN CENTER (ALTOS CINE) SUITE 204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7007
Practice Address - Country:US
Practice Address - Phone:787-789-3790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty