Provider Demographics
NPI:1982670931
Name:PENA, JOSE ROLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ROLANDO
Last Name:PENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 43001
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-6600
Mailing Address - Country:US
Mailing Address - Phone:787-887-7837
Mailing Address - Fax:787-887-0020
Practice Address - Street 1:K2 CALLE 4
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-2823
Practice Address - Country:US
Practice Address - Phone:787-887-7837
Practice Address - Fax:787-887-0020
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2022-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR11221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine