Provider Demographics
NPI:1609855790
Name:ESPIET MIRAY, JUAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:ESPIET MIRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JUAN
Other - Middle Name:A
Other - Last Name:ESPIET MIRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:431 AVE PONCE DE LEON
Mailing Address - Street 2:NATIONAL PLAZA SUITE701
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3418
Mailing Address - Country:US
Mailing Address - Phone:787-754-3227
Mailing Address - Fax:787-766-3236
Practice Address - Street 1:431 AVE PONCE DE LEON
Practice Address - Street 2:NATIONAL PLAZA SUITE701
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3418
Practice Address - Country:US
Practice Address - Phone:787-754-3227
Practice Address - Fax:787-766-3236
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6033207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE2047OtherPALIC
PR065885OtherCRUZ AZUL
PR9190074OtherHUMANA
PR97539OtherTRIPLE S
PR8274OtherFIRST MEDICA
PR4906033OtherUIA
PR21044OtherPREFERED HEALTH
PR36033OtherMEDICAL CARD SYSTEM
PR21044OtherPREFERED HEALTH
PR8274OtherFIRST MEDICA