Basic Information
| Provider Information | |||||||||
| NPI: | 1992259659 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOY GROUP CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 3 BOX 31531 | ||||||||
| Address2: | |||||||||
| City: | AGUADA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006029757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872382923 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 CALLE CONCEPCION VERA | ||||||||
| Address2: | |||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006765005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878778000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2016 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | MIRANDA GALLOZA | ||||||||
| AuthorizedOfficialFirstName: | MIRELIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 7874311741 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 16589 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.