Provider Demographics
NPI:1013910132
Name:ZAITER TERC, JUAN (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:ZAITER TERC
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:AVE PONCE DE LEON
Mailing Address - Street 2:TORRE MEDICA DEL AUXILIO MUTUO SUITE 816
Mailing Address - City:SAN JUAN
Mailing Address - State:SAN JUAN
Mailing Address - Zip Code:00917
Mailing Address - Country:DO
Mailing Address - Phone:787-763-1025
Mailing Address - Fax:787-250-1928
Practice Address - Street 1:AVE PONCE DE LEON 735
Practice Address - Street 2:TORRE MEDICA DEL AUXILIO MUTUO SUITE 816
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00917
Practice Address - Country:DO
Practice Address - Phone:787-763-1025
Practice Address - Fax:787-250-1928
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4945174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE15333Medicare UPIN