Provider Demographics
NPI:1265493647
Name:TIRADO OTERO, MARIA DE LOS A (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DE LOS A
Last Name:TIRADO OTERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9358
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-9358
Mailing Address - Country:US
Mailing Address - Phone:787-269-6362
Mailing Address - Fax:787-269-6363
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:EDIF MEDICO SANTA CRUZ SUITE 415
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-269-6362
Practice Address - Fax:787-269-6363
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9675208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice