Provider Demographics
NPI:1356339881
Name:ARIAS, PEDRO ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:ENRIQUE
Last Name:ARIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PEDRO
Other - Middle Name:ENRIQUE
Other - Last Name:ARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:38 PASEO SAN FELIPE
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:939-940-5343
Mailing Address - Fax:
Practice Address - Street 1:104 AVE CATALINA
Practice Address - Street 2:BARRIO HATO ABAJO, SECTOR BARRANCAS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16079208D00000X
PR16078208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-47465Medicare UPIN