Provider Demographics
NPI:1083057442
Name:IM PRECISION MEDICAL GROUP PSC
Entity Type:Organization
Organization Name:IM PRECISION MEDICAL GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUARBE ARRILLAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-247-4463
Mailing Address - Street 1:PO BOX 13756
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-3756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 CALLE FLOR GERENA N
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4288
Practice Address - Country:US
Practice Address - Phone:787-518-0104
Practice Address - Fax:939-307-8272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty