Provider Demographics
NPI:1861485625
Name:VALDES COCHRAN, JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:VALDES COCHRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CALLE ARMONIA
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-7800
Mailing Address - Country:US
Mailing Address - Phone:787-642-1641
Mailing Address - Fax:787-743-3273
Practice Address - Street 1:URB MENDEZ A2
Practice Address - Street 2:SUITE 1
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-705-9205
Practice Address - Fax:787-705-9206
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15471208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
002-2825Medicare ID - Type Unspecified
PRI-23075Medicare UPIN