Provider Demographics
NPI:1023456860
Name:ORTHOPAEDICS AND ARTHROSCOPIC INSTITUTE
Entity type:Organization
Organization Name:ORTHOPAEDICS AND ARTHROSCOPIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDIL
Authorized Official - Middle Name:O
Authorized Official - Last Name:JIMENEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-475-3747
Mailing Address - Street 1:116 CALLE JUAN LINES RAMOS
Mailing Address - Street 2:URB FRONTERAS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-2915
Mailing Address - Country:US
Mailing Address - Phone:787-475-3747
Mailing Address - Fax:787-854-1452
Practice Address - Street 1:BAYAMON MEDICAL PLAZA
Practice Address - Street 2:PISO 7 SUITE 701
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-798-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18438207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty