Provider Demographics
NPI:1245437441
Name:MASSANET-VOLLRATH, JOSE M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:MASSANET-VOLLRATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:M
Other - Last Name:MASSANET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:BE32 CALLE F
Mailing Address - Street 2:VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4663
Mailing Address - Country:US
Mailing Address - Phone:787-508-5243
Mailing Address - Fax:
Practice Address - Street 1:EDIF HERMANAS DAVILAS STE B206
Practice Address - Street 2:CALLE J ESQUINA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5041
Practice Address - Country:US
Practice Address - Phone:787-740-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104420207XS0117X
PR16891207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine