Provider Demographics
NPI:1285980052
Name:PLATINUM EMERGENCY PHYSICIANS, PSC
Entity type:Organization
Organization Name:PLATINUM EMERGENCY PHYSICIANS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-366-7726
Mailing Address - Street 1:130 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 359, SUITE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6018
Mailing Address - Country:US
Mailing Address - Phone:787-366-7726
Mailing Address - Fax:
Practice Address - Street 1:CARR 129 KM 0.1
Practice Address - Street 2:AVE SAN LUIS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-7275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13958207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty