Provider Demographics
NPI:1447395025
Name:PANELLI, JOSE ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ENRIQUE
Last Name:PANELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PASEO VILLA FLORES 1681
Mailing Address - Street 2:SUITE 203 LORAINE MEDICAL CTR
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-844-7711
Mailing Address - Fax:787-844-7711
Practice Address - Street 1:PASEO VILLA FLORES 1681
Practice Address - Street 2:SUITE 203 LORAINE MEDICAL CTR
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-844-7711
Practice Address - Fax:787-844-7711
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR11076208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics