Provider Demographics
NPI:1407990039
Name:TULL ABREU, JUAN JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:TULL ABREU
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:CALLE 16 Q4 URB VISTA AZUL
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-814-4318
Mailing Address - Fax:787-814-4318
Practice Address - Street 1:CARR 602 KM 0.5
Practice Address - Street 2:BO ANGELES
Practice Address - City:ANGELES
Practice Address - State:PR
Practice Address - Zip Code:00611
Practice Address - Country:US
Practice Address - Phone:787-814-4318
Practice Address - Fax:787-814-4318
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13962208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice