Doctor Name: | MARIO ALFONSO AGRAIT |
NPI Number: | 1124165279 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 10333 |
Business Practice Address: | L17 Ave Magnolia Magnolia Gardens Bayamon, PR - 009562606 |
Business Phone Number: | 7876350889 |
Business Fax Number: | 7877206680 |
Mailing Address: | Po Box 360414, SAN JUAN |
State: | PR |
Postal Code: | 009360414 |
Phone Number: | 7876350889 |
Fax Number: | 7877206680 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 10333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |