Provider Demographics
NPI:1528363488
Name:BJR WOUND CARE
Entity Type:Organization
Organization Name:BJR WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BADER
Authorized Official - Middle Name:JABER
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-602-1732
Mailing Address - Street 1:C/ MARGINAL 181 B-2 URB. TOWN PARK
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-765-6523
Mailing Address - Fax:787-293-0998
Practice Address - Street 1:AVE. LUIS MINOZ SOUFRRONT #500
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-765-6523
Practice Address - Fax:787-293-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care