Provider Demographics
NPI:1073578068
Name:CANTELLOPS, JOSE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:CANTELLOPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BALDWIN PARK ,SOUTHVIEW ST.
Mailing Address - Street 2:B-22
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-731-2721
Mailing Address - Fax:
Practice Address - Street 1:65 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 601
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6900
Practice Address - Country:US
Practice Address - Phone:787-740-4747
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10867174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist