Provider Demographics
NPI:1427018340
Name:SARMIENTO, JESUS BOANERGES (MD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:BOANERGES
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:618 CALLE TURIN
Mailing Address - Street 2:ESTANCIAS DE TORTUGUERO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3604
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:787-621-3710
Practice Address - Street 1:MANATI PLZ
Practice Address - Street 2:URBANIZACION ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-6204
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:787-621-3710
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR10349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82808Medicaid
PR82808Medicaid
PRF28768Medicare UPIN