Provider Demographics
NPI:1417178799
Name:NAZARIO-TOSSAS, ANTONIO J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:J
Last Name:NAZARIO-TOSSAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:LAUREL D-10
Mailing Address - Street 2:HACIENDAS DE DORADO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-955-1198
Mailing Address - Fax:787-767-3968
Practice Address - Street 1:HOSPITAL INDUSTRIAL-CENTRO MEDICO
Practice Address - Street 2:BO. MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:787-767-3968
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR3540208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3540OtherSTATE LICENSE
PR02305DM-1OtherNARCOTICS STATE LICENSE
AN 8775035OtherFEDERAL NARCOTICS LICENSE