Provider Demographics
NPI:1992727002
Name:ADORNO GIUSTI, JORGE
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:ADORNO GIUSTI
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:AJ16 CALLE SONIA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-4918
Mailing Address - Country:US
Mailing Address - Phone:787-785-5487
Mailing Address - Fax:787-786-9100
Practice Address - Street 1:CALLE SONIA AJ-16
Practice Address - Street 2:URB VILLA RICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-5487
Practice Address - Fax:787-786-9100
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1477643021Medicaid