Provider Demographics
NPI:1942243415
Name:SUAREZ-PESANTE, JUAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:R
Last Name:SUAREZ-PESANTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 33067
Mailing Address - Street 2:VETERANS PLAZA STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00933-3067
Mailing Address - Country:US
Mailing Address - Phone:787-641-2975
Mailing Address - Fax:787-641-4380
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:ATTN: SURGICAL SERVICE (112)
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-2975
Practice Address - Fax:787-641-4380
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11454207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRN620OtherFIRST MEDICAL
PR87705OtherTRIPLE S
PR9180422OtherHUMANA
PR9180422OtherHUMANA
PRF83925Medicare UPIN