Provider Demographics
NPI:1639420771
Name:JVT MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:JVT MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PRIMARY PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARICARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-792-3203
Mailing Address - Street 1:96 VALLE ESCONDIDO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-792-3203
Mailing Address - Fax:787-273-6970
Practice Address - Street 1:864 AVE SAN PATRICIO
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1308
Practice Address - Country:US
Practice Address - Phone:787-792-3203
Practice Address - Fax:787-273-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5441261QP2300X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care