Provider Demographics
NPI:1104226000
Name:JAVIER I ARROYO CAMUNAS MD PSC
Entity type:Organization
Organization Name:JAVIER I ARROYO CAMUNAS MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-285-2395
Mailing Address - Street 1:PO BOX 9122
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9122
Mailing Address - Country:US
Mailing Address - Phone:787-285-2395
Mailing Address - Fax:787-850-5235
Practice Address - Street 1:201 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3310
Practice Address - Country:US
Practice Address - Phone:787-285-2395
Practice Address - Fax:787-850-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13760207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH42298Medicare UPIN
PR0020610Medicare PIN