Provider Demographics
NPI:1396436754
Name:DOBLE CACHO, JAN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JAN PAUL
Middle Name:
Last Name:DOBLE CACHO
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:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4055
Mailing Address - Country:US
Mailing Address - Phone:787-658-0012
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL BUEN SAMARITANO
Practice Address - Street 2:CARR. EST. PR-460, KM. 0.2
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16509I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program