Provider Demographics
NPI:1285217950
Name:PELAEZ PALOU, JUAN ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:ALBERTO
Last Name:PELAEZ PALOU
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:COND MONTE DE LOS FRAILES
Mailing Address - Street 2:7 CALLE UNION APT 105
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-7202
Mailing Address - Country:US
Mailing Address - Phone:787-810-9192
Mailing Address - Fax:
Practice Address - Street 1:COND MONTE DE LOS FRAILES
Practice Address - Street 2:7 CALLE UNION APT 105
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971-7202
Practice Address - Country:US
Practice Address - Phone:787-810-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23617208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice