Provider Demographics
NPI:1598709768
Name:MARIN ESPIET, JUAN R
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:R
Last Name:MARIN ESPIET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 3 CASA E-2
Mailing Address - Street 2:URB. OCEAN VIEW
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3510
Mailing Address - Country:US
Mailing Address - Phone:787-643-4747
Mailing Address - Fax:
Practice Address - Street 1:CARR 486 KM. 0.2
Practice Address - Street 2:BO. PUENTE
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-898-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14040208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H98825Medicare UPIN