Provider Demographics
NPI:1780114892
Name:SAENZ MAISONET, JEAN FRANC
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:FRANC
Last Name:SAENZ MAISONET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 AVE ARTERIAL HOSTOS APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2997
Mailing Address - Country:US
Mailing Address - Phone:787-237-1871
Mailing Address - Fax:
Practice Address - Street 1:E13 CALLE BIANCA
Practice Address - Street 2:ANDREA'S COURT
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-237-1871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR155791835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program