Provider Demographics
NPI:1043336969
Name:MONASTERIO, JESUS (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:
Last Name:MONASTERIO
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 PONCE BY PASS
Mailing Address - Street 2:PARRA MEDICAL PLAZA SUITE 408
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1322
Mailing Address - Country:US
Mailing Address - Phone:787-848-8203
Mailing Address - Fax:787-848-8204
Practice Address - Street 1:2225 PONCE BY PASS
Practice Address - Street 2:PARRA MEDICAL PLAZA SUITE 408
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-848-8203
Practice Address - Fax:787-848-8204
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8704208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29839Medicare ID - Type Unspecified
PRD34212Medicare UPIN