Marcos Antonio Justinano, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

12205 Issued in PR

Practice address

Plaza Gabriela Bo. Canas
Carr. 132 KM 22.1
Ponce, PR 00728

Phone

(787) 812-3930

Fax

(787) 812-3931

NPI assigned

Jun 22, 2006

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1598701724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 AVE MUNOZ RIVERA",
            "address_2": "PMB 250",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170211",
            "telephone_number": "787-644-6323",
            "fax_number": "787-644-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA GABRIELA BO. CANAS",
            "address_2": "CARR. 132 KM 22.1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00728",
            "telephone_number": "787-812-3930",
            "fax_number": "787-812-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINANO",
        "first_name": "MARCOS",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "12205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valeria Sofia Julia
• Kenneth Joel Junco Nieves, PH.D.
• Kelene M Jusino Colon
• Edwin Jusino Quinones, OD
• Alejandra Jusino Torres
• Lizbette Justiniano, M. D.
• Lellanes Justiz Hernandez
• Llanilys Justiz Hernandez, M.D.
• K&P Medical Supply Distributors, Corp
• Kartal Med Services

• Pediatrics Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.