Provider Demographics
NPI:1336034743
Name:NASSAR, JUAN
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:NASSAR
Suffix:
Gender:M
Credentials:
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 9132
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9132
Mailing Address - Country:US
Mailing Address - Phone:787-920-1415
Mailing Address - Fax:
Practice Address - Street 1:LUIS A. FERRE HIGHWAY EXIT #21 ROAD 172 CAGUAS
Practice Address - Street 2:
Practice Address - City:TURABO GARDENS CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-743-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program