Provider Demographics
NPI:1336144492
Name:BAUZA, JULIO C (MD)
Entity Type:Individual
Prefix:PROF
First Name:JULIO
Middle Name:C
Last Name:BAUZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIO
Other - Middle Name:C
Other - Last Name:BAUZA
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:55 DORADO BCH E
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2049
Mailing Address - Country:US
Mailing Address - Phone:787-278-3514
Mailing Address - Fax:
Practice Address - Street 1:SAN JORGE MEDICAL BUILDING
Practice Address - Street 2:403
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-268-0665
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR51282080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5128OtherSTATE LICENSE