Provider Demographics
NPI:1982124145
Name:JPM ENT SURGICAL LLC
Entity Type:Organization
Organization Name:JPM ENT SURGICAL LLC
Other - Org Name:JPM ENT SURGICAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCUAL MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:787-406-0301
Mailing Address - Street 1:PO BOX 23318
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00931-3318
Mailing Address - Country:US
Mailing Address - Phone:787-406-0301
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA ASHFORD #1451
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00902
Practice Address - Country:US
Practice Address - Phone:787-721-2160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR019538207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty