Provider Demographics
NPI:1700758745
Name:JD RENAL LLC
Entity type:Organization
Organization Name:JD RENAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORTIZ ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-504-4936
Mailing Address - Street 1:A8 VIA HORIZONTE
Mailing Address - Street 2:URB LA VISTA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4461
Mailing Address - Country:US
Mailing Address - Phone:787-886-3254
Mailing Address - Fax:787-957-1555
Practice Address - Street 1:B1 CALLE 1
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-4116
Practice Address - Country:US
Practice Address - Phone:787-886-3254
Practice Address - Fax:787-957-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty