Provider Demographics
NPI:1356847107
Name:ANZALOTA DEL TORO, MIGUEL JAVIER (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:JAVIER
Last Name:ANZALOTA DEL TORO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10 CALLE CASIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3200
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:787-641-4561
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-4561
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22639207R00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program