Provider Demographics
NPI:1245292614
Name:HERRERA, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:HERRERA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1771 CALLE ANDROMEDA
Mailing Address - Street 2:URB VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4922
Mailing Address - Country:US
Mailing Address - Phone:787-748-1749
Mailing Address - Fax:787-777-3702
Practice Address - Street 1:BO. MONACILLOS CARR. 22
Practice Address - Street 2:PASEO DR. CELSO BARBOSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3702
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR15966208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice