Provider Demographics
NPI:1588136923
Name:TD MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:TD MEDICAL SERVICES LLC
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 VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-545-2718
Mailing Address - Street 1:130 WINSTON CHURCHILL AVE
Mailing Address - Street 2:PMB 359 SUITE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0734
Mailing Address - Country:US
Mailing Address - Phone:787-545-2718
Mailing Address - Fax:787-545-2794
Practice Address - Street 1:B9 SIERRA LINDA CARR 681
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-545-2718
Practice Address - Fax:787-545-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies