Provider Demographics
NPI:1972716884
Name:PRIETO, JOSE MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MANUEL
Last Name:PRIETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:MANUEL
Other - Last Name:PRIETO-MELENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:224 CALLE VIENA
Mailing Address - Street 2:URB. COLLEGE PARK 4
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4804
Mailing Address - Country:US
Mailing Address - Phone:787-758-0898
Mailing Address - Fax:
Practice Address - Street 1:224 CALLE VIENA
Practice Address - Street 2:URB. COLLEGE PARK 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4804
Practice Address - Country:US
Practice Address - Phone:787-758-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology