Provider Demographics
NPI:1356575658
Name:JMR MEDICAL SERVICES INC.
Entity type:Organization
Organization Name:JMR MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNYMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-895-4583
Mailing Address - Street 1:HC 02
Mailing Address - Street 2:BOX 8356
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:787-895-4583
Mailing Address - Fax:787-895-4583
Practice Address - Street 1:HC02 BOX 8356
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00678
Practice Address - Country:UM
Practice Address - Phone:787-895-4583
Practice Address - Fax:787-895-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14968208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-25699Medicare UPIN