Provider Demographics
NPI:1467564930
Name:VILARO-CHARDON, JUAN LUIS (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:LUIS
Last Name:VILARO-CHARDON
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 1:49 VIGIA ST
Mailing Address - Street 2:MANSION DEL SUR
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2085
Mailing Address - Country:US
Mailing Address - Phone:787-840-1658
Mailing Address - Fax:787-840-1658
Practice Address - Street 1:EDIFICIO PARRA
Practice Address - Street 2:SUITE 302
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732
Practice Address - Country:US
Practice Address - Phone:787-844-1248
Practice Address - Fax:787-840-1658
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10908207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F60796Medicare UPIN
0088660Medicare ID - Type Unspecified