Provider Demographics
NPI:1376900977
Name:JJRE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:JJRE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIVERA ESPARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-207-4297
Mailing Address - Street 1:5005 CONSTANCIA
Mailing Address - Street 2:HACIENDAS DEL MONTE
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-973-0010
Mailing Address - Fax:
Practice Address - Street 1:623 AVE LA CEIBA ROVIRA OFFICE PARK SUITE 103
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-973-0010
Practice Address - Fax:787-973-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14200OtherLIC