Provider Demographics
NPI:1649494071
Name:ALMONTE-DURAN, VINICIO A (MD)
Entity type:Individual
Prefix:
First Name:VINICIO
Middle Name:A
Last Name:ALMONTE-DURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VINICIO
Other - Middle Name:A
Other - Last Name:ALMONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PMB 206
Mailing Address - Street 2:220 WESTERN AUTO PLAZA SUITE 101
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3607
Mailing Address - Country:US
Mailing Address - Phone:787-287-2692
Mailing Address - Fax:
Practice Address - Street 1:STA CRUZ #70
Practice Address - Street 2:URB. SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-0000
Practice Address - Country:US
Practice Address - Phone:787-620-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9756207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG 41635Medicare UPIN