Provider Demographics
NPI:1336137462
Name:ARIAS, FELIPE JUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:JUAN
Last Name:ARIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FELIPE
Other - Middle Name:JUAN
Other - Last Name:ARIAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:CONDOMINIO HARBOR PLAZA
Mailing Address - Street 2:105 PASEO CONCEPCION DE GRACIA APTO. 605
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2689
Mailing Address - Country:US
Mailing Address - Phone:787-508-0177
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO HARBOR PLAZA
Practice Address - Street 2:105 PASEO CONCEPCION DE GRACIA APTO. 605
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2689
Practice Address - Country:US
Practice Address - Phone:787-508-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR135972085R0202X, 2085R0202X
PAMD4224602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272537100Medicaid
FL16035ZMedicare PIN