Provider Demographics
NPI:1851158497
Name:YABUCOAMED LLC
Entity Type:Organization
Organization Name:YABUCOAMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-642-1641
Mailing Address - Street 1:PO BOX 8806
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8806
Mailing Address - Country:US
Mailing Address - Phone:787-705-9205
Mailing Address - Fax:787-705-9206
Practice Address - Street 1:CALLE BALDORIOTY 4
Practice Address - Street 2:EL SAPO BO. CALABAZAS
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-0076
Practice Address - Country:US
Practice Address - Phone:787-705-9205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care