Provider Demographics
NPI:1356351746
Name:ARIAS, JOSE I (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:I
Last Name:ARIAS
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 1:60ST. BA-5
Mailing Address - Street 2:URB. HILL MANSIONS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-761-7752
Mailing Address - Fax:
Practice Address - Street 1:CALLE LODI #A-1
Practice Address - Street 2:URB. VILLA LUARCA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-766-1262
Practice Address - Fax:787-758-3308
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-009341Medicare ID - Type UnspecifiedDOCTOR IN INTERNAL MEDICI