Provider Demographics
NPI:1740043702
Name:CARTAGENA LEBRON, JULIO GUSTAVO
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:GUSTAVO
Last Name:CARTAGENA LEBRON
Suffix:
Gender:M
Credentials:
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 60401, PMB 33
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690
Mailing Address - Country:US
Mailing Address - Phone:787-324-4914
Mailing Address - Fax:
Practice Address - Street 1:1010 CALLE 30 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2340
Practice Address - Country:US
Practice Address - Phone:787-324-4914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program