Provider Demographics
NPI:1811004492
Name:GIRON MOREL, JESSIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:
Last Name:GIRON MOREL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 CALLE MAR MEDITERRANEO
Mailing Address - Street 2:PASEO LOS CORALES II
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4535
Mailing Address - Country:US
Mailing Address - Phone:787-253-4080
Mailing Address - Fax:
Practice Address - Street 1:6772 AV. ISLA VERDE SUITE 101-A
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-253-4080
Practice Address - Fax:787-710-9878
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0024004Medicare ID - Type UnspecifiedMEDICARE PART B