Provider Demographics
NPI:1952491417
Name:TOSSAS, RAYMOND IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:IVAN
Last Name:TOSSAS
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 1:65 CALLE DR SANTIAGO VEVE
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4113
Mailing Address - Country:US
Mailing Address - Phone:787-264-1214
Mailing Address - Fax:787-264-1214
Practice Address - Street 1:65 CALLE DR SANTIAGO VEVE
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4113
Practice Address - Country:US
Practice Address - Phone:787-264-1214
Practice Address - Fax:787-264-1214
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12753208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89481TMedicare UPIN