Provider Demographics
NPI:1083719124
Name:VALDERRABANO, JOSE L (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:VALDERRABANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 CALLE TULIPAN
Mailing Address - Street 2:URB. SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6221
Mailing Address - Country:US
Mailing Address - Phone:787-763-2032
Mailing Address - Fax:787-281-6395
Practice Address - Street 1:208 CALLE TULIPAN
Practice Address - Street 2:URB. SAN FRANCISCO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6221
Practice Address - Country:US
Practice Address - Phone:787-763-2032
Practice Address - Fax:787-281-6395
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR61952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology