Doctor Name: | MR. JUAN R MARIN |
NPI Number: | 1164454351 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 3917 |
Business Practice Address: | Adult University Hopsital Medical Center Car #22 Centro Medico, Clinica Empleado Rio Piedras, PR - 00935 |
Business Phone Number: | 7877540101 |
Business Fax Number: | 7872943620 |
Mailing Address: | Po Box 192426, SAN JUAN |
State: | PR |
Postal Code: | 009192426 |
Phone Number: | 7876474777 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 3917 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |