MJ New Life Medical Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

08-P-1799 Issued in PR

Legal business name

MJ NEW LIFE MEDICAL CORP

Practice address

Ik28 Ave Nogal
Royal Palm
Bayamon, PR 00956-2973

Phone

(787) 269-7879

Fax

(787) 269-0668

NPI assigned

Jun 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jose Antonio Casiano Jr.

Title

President Owner

Phone

(787) 269-7879

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144257247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 116",
            "address_2": "BOX 607071",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009607071",
            "fax_number": "787-269-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IK28 AVE NOGAL",
            "address_2": "ROYAL PALM",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009562973",
            "telephone_number": "787-269-7879",
            "fax_number": "787-269-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ NEW LIFE MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASIANO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "787-269-7879",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PR",
            "license": "08-P-1799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Durable Medical Equipment & Medical Supplies in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.