Jose Juan Forty Diaz | San Juan, PR • PECOS Search

Jose Juan Forty Diaz

Student in an Organized Health Care Education/Training Program

Student, Health Care

Centro Medico San Juan Puerto Rico Barrio Monacillos, San Juan, PR 00935-0001

PECOS Enrollment

Based on the most recent information from CMS, provider Jose Juan Forty Diaz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1740874916
Provider Type
Individual
Full Name
Forty Diaz, Jose Juan
Gender
Male

Sole Proprietor
No
Enumeration Date
2/26/2021
Last Updated
2/26/2021

Contact Information

Practice Location

Centro Medico San Juan Puerto Rico Barrio Monacillos, San Juan, PR 00935-0001

Unlisted Fax

Mailing Location

PO Box 365067, San Juan, PR 00936-5067

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer