Provider Demographics
NPI:1225155864
Name:MEDINA-JUARBE, ARTURO (MD)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:MEDINA-JUARBE
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:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0383
Mailing Address - Country:US
Mailing Address - Phone:787-504-4039
Mailing Address - Fax:787-856-3380
Practice Address - Street 1:13 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3640
Practice Address - Country:US
Practice Address - Phone:787-856-3380
Practice Address - Fax:787-856-3380
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5840OtherMEDICAL LICENSE
PR27924MEMedicare ID - Type Unspecified
PR5840OtherMEDICAL LICENSE