Provider Demographics
NPI:1750390589
Name:FELIU BAEZ, JOSE MIGUEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MIGUEL
Last Name:FELIU BAEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 5314
Mailing Address - Street 2:CUC STATION
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00739-5314
Mailing Address - Country:US
Mailing Address - Phone:787-738-5573
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 14 KM 71.6
Practice Address - Street 2:BO MONTE LLANO
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-5573
Practice Address - Fax:
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
PR22411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice