Provider Demographics
NPI:1104028307
Name:ABUOMAR, JUMANA (MD)
Entity Type:Individual
Prefix:DR
First Name:JUMANA
Middle Name:
Last Name:ABUOMAR
Suffix:
Gender:F
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:PO BOX 1358
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1358
Mailing Address - Country:US
Mailing Address - Phone:787-886-3254
Mailing Address - Fax:787-957-1555
Practice Address - Street 1:VILLAS DE LOIZA CALLE 1 BLOQUE B1
Practice Address - Street 2:ALTOS FARMACIA MEDINA II
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-886-3254
Practice Address - Fax:787-957-1555
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16751207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028812Medicare PIN