Provider Demographics
NPI:1700853702
Name:ITURREGUI, MIGUEL MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:MANUEL
Last Name:ITURREGUI
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:PONCE DE LEON #735
Mailing Address - Street 2:TORRE MEDICA AUXILIO MUTUO OFIC 603
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-294-0943
Mailing Address - Fax:
Practice Address - Street 1:PONCE DE LEON #735
Practice Address - Street 2:TORRE MEDICA AUXILIO MUTUO OFIC 603
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-294-0943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15702208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI28636Medicare UPIN
PR0090398EMedicare ID - Type Unspecified