JC Fast Clinic LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

JC FAST CLINIC LLC

Practice address

610 Ave Comerio Final
Sup Econo Levittown
Toa Baja, PR 00949

Phone

(787) 784-2218

Fax

(787) 784-3444

NPI assigned

Jun 12, 2019

Last updated

Jun 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorge Cedeno Espaillat, MDNPI 1316171168

Title

Owner

Phone

(787) 784-2218

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jorge Cedeno Espaillat, 17552

  • General Practice Physician
  • Toa Baja, PR
  • NPI 1316171168
  Medicare reassignment NPD Authorized official
• Jose Vidal Ramos, PSY.D.

  • Clinical Psychologist
  • Toa Baja, PR
  • NPI 1669815908
  Medicare reassignment NPD
• Omar Berrios Torres, MD

  • General Practice Physician
  • Bayamon, PR
  • NPI 1962005637

  Single Specialty

  NPD (past)
• Ayeisha Escartin, MD

  • General Practice Physician
  • Toa Baja, PR
  • NPI 1770247249
  NPD (past)

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1861051906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ME10 URB MARINA BAHIA",
            "address_2": "PLAZA 20",
            "city": "CATANO",
            "state": "PR",
            "postal_code": "00962",
            "telephone_number": "787-518-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 AVE COMERIO FINAL",
            "address_2": "SUP ECONO LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-784-2218",
            "fax_number": "787-784-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC FAST CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "CEDENO ESPAILLAT",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-784-2218",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisandra Isaac, PHARMD
• Isanis Principe Dba Farmacia Marlene
• Fernando Janer Sanchez, ND, MSW
• Jasaes Medical Diagnostic
• Walter Javier, D.M.D.
• JC Physiatry LLC
• Jenny Rivera Farmacia Lesmarie (Farmacia Lesmarie)
• Omayra Jimenez Barreto, LND
• Yodali Jimenez Fuentes, LND
• Jose Victor Jimenez, MSW

• General Practice Physician in Toa Baja, PR
• Providers in Toa Baja, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.