Provider Demographics
NPI:1346215936
Name:BERMUDEZ SEGARRA, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:BERMUDEZ SEGARRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:#100 PASEO SAN PABLO
Mailing Address - Street 2:SUITE 408
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7028
Mailing Address - Country:US
Mailing Address - Phone:787-787-1060
Mailing Address - Fax:787-785-7421
Practice Address - Street 1:PASEO SAN PABLO #100
Practice Address - Street 2:EDIF. DR. ARTURO CADILLA SUITE 408
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7028
Practice Address - Country:US
Practice Address - Phone:787-787-1060
Practice Address - Fax:787-785-9421
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9282207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE21111Medicare UPIN