Provider Demographics
NPI:1124026661
Name:SOSA, CANDELARIO A (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:CANDELARIO
Middle Name:A
Last Name:SOSA
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CALLE LOS ALPES
Mailing Address - Street 2:EXT. EL COMANDANTE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-3641
Mailing Address - Country:US
Mailing Address - Phone:787-752-4491
Mailing Address - Fax:
Practice Address - Street 1:202 CALLE LOS ALPES
Practice Address - Street 2:EXT. EL COMANDANTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-3641
Practice Address - Country:US
Practice Address - Phone:787-752-4491
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9812208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
81902Medicare ID - Type Unspecified
E78372Medicare UPIN