| Doctor Name: | DR. JUAN ANTONIO CEBOLLERO |
| NPI Number: | 1164855185 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 18563 |
| Business Practice Address: | Urb Valle Verde Calle Arboleda #955 Ponce, PR - 007160000 |
| Business Phone Number: | 7876018736 |
| Business Fax Number: | |
| Mailing Address: | Calle Arboleda #955, Urb Valle Verde PONCE |
| State: | PR |
| Postal Code: | 007160000 |
| Phone Number: | 7876018736 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2013 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18563 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |