Basic Information
| Provider Information | |||||||||
| NPI: | 1902534928 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JCG MEDICAL EMERGENCY SERVICES PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3205 AVENIDA ISLA VERDE | ||||||||
| Address2: | CONDOMINIO THE GALAXY 1606 | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875283329 | ||||||||
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| Practice Location | |||||||||
| Address1: | HOSPITAL DR RAMON RUIZ ARNAU | ||||||||
| Address2: | AVE LAUREL SANTA JUANITA | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877875151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2022 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | COLON GRAU | ||||||||
| AuthorizedOfficialFirstName: | JOSE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7875283329 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.