Provider Demographics
NPI:1639134554
Name:HOEPELMAN, BARON (MD)
Entity Type:Individual
Prefix:
First Name:BARON
Middle Name:
Last Name:HOEPELMAN
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 1:2525 AVE E RUBERTE
Mailing Address - Street 2:COLISEO SHOPPING CENTER STE 212
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1712
Mailing Address - Country:US
Mailing Address - Phone:787-840-9708
Mailing Address - Fax:787-840-9708
Practice Address - Street 1:2525 AVE E RUBERTE
Practice Address - Street 2:COLISEO SHOPPING CENTER STE 212
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1712
Practice Address - Country:US
Practice Address - Phone:787-840-9708
Practice Address - Fax:787-840-9708
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3245208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0023503OtherTRIPLE S
0023503Medicare ID - Type Unspecified