Provider Demographics
NPI:1437698826
Name:J&K MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:J&K MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-617-3558
Mailing Address - Street 1:AN2 CALLE 31
Mailing Address - Street 2:REPARTO TERESITA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-263-9338
Mailing Address - Fax:787-263-9338
Practice Address - Street 1:10 CALLE LUIS BARRERA
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-263-9338
Practice Address - Fax:787-263-9338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty