Provider Demographics
NPI:1124590732
Name:PLATINUM HEALTH CARE MANAGEMENT GROUP LLC
Entity Type:Organization
Organization Name:PLATINUM HEALTH CARE MANAGEMENT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-366-7726
Mailing Address - Street 1:130 WINSTON CHURCHILL AVE
Mailing Address - Street 2:PMB 359 SUITE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0734
Mailing Address - Country:US
Mailing Address - Phone:787-545-2718
Mailing Address - Fax:787-545-2794
Practice Address - Street 1:121 URB EL VEDADO CALLE LOAIZA CORDERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-545-2718
Practice Address - Fax:787-545-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical