Provider Demographics
NPI:1922165448
Name:ANGULO JOHNSON, ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:ANGULO JOHNSON
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:HACIENDAS DE BORINQUEN II
Mailing Address - Street 2:18 CALLE CEIBA
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-9538
Mailing Address - Country:US
Mailing Address - Phone:787-637-4548
Mailing Address - Fax:787-897-4952
Practice Address - Street 1:HACIENDAS DE BORINQUEN II
Practice Address - Street 2:18 CALLE CEIBA
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-9538
Practice Address - Country:US
Practice Address - Phone:787-637-4548
Practice Address - Fax:787-897-4952
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine