Provider Demographics
NPI:1457331688
Name:TRINIDAD-PINEDO, JUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:TRINIDAD-PINEDO
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:PO BOX 193070
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3070
Mailing Address - Country:US
Mailing Address - Phone:787-758-6077
Mailing Address - Fax:787-758-1119
Practice Address - Street 1:A6 CALLE UPSALA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4821
Practice Address - Country:US
Practice Address - Phone:787-758-6077
Practice Address - Fax:787-758-1119
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRMD 4283174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE8252Medicare UPIN