Provider Demographics
NPI:1407897994
Name:PALOU ABASOLO, JOSE M (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:PALOU ABASOLO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:140 AVE LAS CUMBRES
Mailing Address - Street 2:GUAYNABO MEDICAL MALL OFIC 201
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5523
Mailing Address - Country:US
Mailing Address - Phone:787-731-5785
Mailing Address - Fax:787-287-2487
Practice Address - Street 1:140 AVE LAS CUMBRES
Practice Address - Street 2:140 AVE LAS CUMBRES OFIC 201
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5523
Practice Address - Country:US
Practice Address - Phone:787-731-5785
Practice Address - Fax:787-287-2487
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2014-06-16
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Provider Licenses
StateLicense IDTaxonomies
PR113792084P0800X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR24458OtherMEDICARE INDIVIDUAL NUMBER