Provider Demographics
NPI:1396819470
Name:PALOU-BOSCH, PEDRO J (MD)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:J
Last Name:PALOU-BOSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:T3-4 CARR 21
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3312
Mailing Address - Country:US
Mailing Address - Phone:787-793-4646
Mailing Address - Fax:787-292-3911
Practice Address - Street 1:T3-4 CARR 21
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3312
Practice Address - Country:US
Practice Address - Phone:787-793-4646
Practice Address - Fax:787-292-3911
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7880207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0099624Medicare ID - Type Unspecified
PRD32376Medicare UPIN