Provider Demographics
NPI:1639296734
Name:PLAUD, JOSE (C A G S)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:PLAUD
Suffix:
Gender:M
Credentials:C A G S
Other - Prefix:MR
Other - First Name:JOSE
Other - Middle Name:
Other - Last Name:PLAUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:C A G S
Mailing Address - Street 1:E10 CALLE MARGINAL
Mailing Address - Street 2:URB. ANAYDA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2558
Mailing Address - Country:US
Mailing Address - Phone:787-259-5990
Mailing Address - Fax:787-259-5990
Practice Address - Street 1:1910 AMERICAS AVE.
Practice Address - Street 2:URB. SAN ANTONIO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-259-5990
Practice Address - Fax:787-259-5990
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR470103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical