1609887272 NPI number — JAGOO INC

Table of content: DR. JUDITH J. LEVINE MD (NPI 1790729416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609887272 NPI number — JAGOO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAGOO INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609887272
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 6 BOX 94610
Provider Second Line Business Mailing Address:
SUITE #2
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00612-9654
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-878-6665
Provider Business Mailing Address Fax Number:
787-650-3976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 129 KM 5.0
Provider Second Line Business Practice Location Address:
BO. HATO ARRIBA
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-9613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-6665
Provider Business Practice Location Address Fax Number:
787-650-3976
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ HERNANDEZ
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
PRESIDENT/ OWNER
Authorized Official Telephone Number:
787-878-6665

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  18-F-2861 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2087519 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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