Provider Demographics
NPI:1497568489
Name:JP ENTERPRISE LLC
Entity type:Organization
Organization Name:JP ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALICEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-934-0664
Mailing Address - Street 1:CALLE #3, 2B-28, VISTA DEL CONVENTO
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-934-0664
Mailing Address - Fax:
Practice Address - Street 1:CARR 188 KM 1.5 PARCELAS NUEVAS
Practice Address - Street 2:BARRIO SAN ISIDRO
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-1358
Practice Address - Fax:787-256-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty