Provider Demographics
NPI:1447389713
Name:FIGUEROA, WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WALTER
Other - Middle Name:
Other - Last Name:LOPEZ FIGUEROA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 29454
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0454
Mailing Address - Country:US
Mailing Address - Phone:787-392-6996
Mailing Address - Fax:787-946-3025
Practice Address - Street 1:893 CALLE EIDER
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-768-6996
Practice Address - Fax:787-946-3025
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130902207R00000X
PR10987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRGO6795Medicare UPIN
PR88688Medicare ID - Type Unspecified