Provider Demographics
NPI:1750462966
Name:DUQUELA, JUAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:L
Last Name:DUQUELA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:EL SENORIAL MAIL STATION 552
Mailing Address - Street 2:WINSTON CHURCHILL AVE. #138
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-720-4207
Mailing Address - Fax:787-731-1829
Practice Address - Street 1:728 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4500
Practice Address - Country:US
Practice Address - Phone:787-751-4295
Practice Address - Fax:787-756-8113
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR3870207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-3875Medicare ID - Type Unspecified
PRC-77204Medicare UPIN