Provider Demographics
NPI:1568699908
Name:MANUEL ANGUITA ALVARADO PSC
Entity Type:Organization
Organization Name:MANUEL ANGUITA ALVARADO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:ANGUITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-294-0940
Mailing Address - Street 1:AVE PONCE DE LEON # 735
Mailing Address - Street 2:TORRE MEDICA AUXILIO MUTUO SUITE 603
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1000
Mailing Address - Country:US
Mailing Address - Phone:787-294-0940
Mailing Address - Fax:787-294-0943
Practice Address - Street 1:AVE PONCE DE LEON # 735
Practice Address - Street 2:TORRE MEDICA AUXILIO MUTUO SUITE 603
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1000
Practice Address - Country:US
Practice Address - Phone:787-294-0940
Practice Address - Fax:787-294-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11389174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty