Provider Demographics
NPI:1407825524
Name:ROBLES, JUAN SATURINO SR (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:SATURINO
Last Name:ROBLES
Suffix:SR
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:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0609
Mailing Address - Country:US
Mailing Address - Phone:787-896-1686
Mailing Address - Fax:787-896-1686
Practice Address - Street 1:70 CALLE SEVERO ARANA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2226
Practice Address - Country:US
Practice Address - Phone:787-896-1686
Practice Address - Fax:787-896-1686
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5209208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C77437Medicare UPIN
PR26595Medicare ID - Type Unspecified