Provider Demographics
NPI:1922534742
Name:JST MEDICAL LLC
Entity Type:Organization
Organization Name:JST MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-929-1121
Mailing Address - Street 1:CAGUAS REAL APARTADO 112
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-929-1121
Mailing Address - Fax:787-839-7997
Practice Address - Street 1:1 CALLE PALMER
Practice Address - Street 2:ESQUINA VICENTE PALES
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-929-1121
Practice Address - Fax:787-839-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty