Provider Demographics
NPI:1457066821
Name:MANUEL NAREDO MD
Entity Type:Organization
Organization Name:MANUEL NAREDO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR-OWNER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAREDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-792-6145
Mailing Address - Street 1:PO BOX 191918
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1918
Mailing Address - Country:US
Mailing Address - Phone:787-792-6145
Mailing Address - Fax:787-782-2774
Practice Address - Street 1:1618 AVENIDA JESUS T. PINEIRO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1423
Practice Address - Country:US
Practice Address - Phone:787-792-6145
Practice Address - Fax:787-782-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty