Provider Demographics
NPI:1255964664
Name:BRETON ARIAS, JOSE MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MIGUEL
Last Name:BRETON ARIAS
Suffix:
Gender:
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:ENSENADA 561, COND. SAN RAFAEL, APT. 4C, MIRAMAR,
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-236-9103
Mailing Address - Fax:
Practice Address - Street 1:1008 AVE. AMERICO MIRANDA
Practice Address - Street 2:CENTRO COMERCIAL RPTO. METROPOLITANO, RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24344207R00000X
PR37075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty