Individual ProviderJorge Carlos Illanas HernandezGeneral PracticeAllopathic & Osteopathic PhysiciansPractice AddressPr #2 Km 156.7, Mayaguez, PR 00680(787) 380-8425PECOS EnrollmentBased on the most recent information from CMS, provider Jorge Carlos Illanas Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1730808395Provider TypeIndividualFull NameIllanas Hernandez, Jorge CarlosTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date8/25/2022Last Updated3/15/2023Contact InformationPractice LocationPractice AddressPr #2 Km 156.7, Mayaguez, PR 00680Phone(787) 380-8425FaxUnlisted FaxMailing LocationMailing AddressPO Box 987, Mayaguez, PR 00681-0987Phone(787) 380-8425FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense23145Puerto RicoCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense15878-IPuerto Rico