Provider Demographics
NPI:1073796082
Name:DE LA PAZ ALEGRET, GUSTAVO ADOLFO (MD)
Entity Type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:ADOLFO
Last Name:DE LA PAZ ALEGRET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CALLE GUAJATACA
Mailing Address - Street 2:CROWN HILLS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6004
Mailing Address - Country:US
Mailing Address - Phone:787-216-5144
Mailing Address - Fax:
Practice Address - Street 1:155 CALLE GUAJATACA
Practice Address - Street 2:CROWN HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6004
Practice Address - Country:US
Practice Address - Phone:787-216-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR16994208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice