Provider Demographics
NPI:1942457890
Name:BILLOCH LIMA, JORGE G (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:G
Last Name:BILLOCH LIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:G
Other - Last Name:BILLOCH LIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 CALLE MANUEL DOMENECH
Mailing Address - Street 2:HATO REY PATHOLOGY LABORATORIES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3509
Mailing Address - Country:US
Mailing Address - Phone:787-765-7320
Mailing Address - Fax:787-765-3230
Practice Address - Street 1:300 CALLE MANUEL DOMENECH
Practice Address - Street 2:HATO REY PATHOLOGY LABORATORIES
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3509
Practice Address - Country:US
Practice Address - Phone:787-765-7320
Practice Address - Fax:787-765-3230
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18369207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology