Provider Demographics
NPI:1508874876
Name:ALMODOVAR - LABORDE, JOSE I (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:I
Last Name:ALMODOVAR - LABORDE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:HC 3 BOX 25716
Mailing Address - Street 2:SAN GERMAN MEDICAL PAZA
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9340
Mailing Address - Country:US
Mailing Address - Phone:787-892-3513
Mailing Address - Fax:787-892-7422
Practice Address - Street 1:CARR. 2 KM 174.0
Practice Address - Street 2:SAN GERMAN MEDICAL PLAZA SUITE 207
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9340
Practice Address - Country:US
Practice Address - Phone:787-892-3513
Practice Address - Fax:787-892-7422
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2024-03-13
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Provider Licenses
StateLicense IDTaxonomies
PR11632207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020351Medicare PIN
PRH82864Medicare UPIN