Provider Demographics
NPI:1407886013
Name:CORREA SUAREZ, JOSE MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MANUEL
Last Name:CORREA SUAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0054
Mailing Address - Country:US
Mailing Address - Phone:787-858-1580
Mailing Address - Fax:787-807-4122
Practice Address - Street 1:HOSPITAL WILMA N VAZQUEZ
Practice Address - Street 2:BOX 7001
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00694-7001
Practice Address - Country:US
Practice Address - Phone:787-858-1580
Practice Address - Fax:787-807-4122
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR4321207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77264Medicare UPIN
PR0024842Medicare ID - Type Unspecified