Provider Demographics
NPI:1770531733
Name:JONES, JOHN ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALEXANDER
Last Name:JONES
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 1:416 CALLE LUNA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-1431
Mailing Address - Country:US
Mailing Address - Phone:787-729-0093
Mailing Address - Fax:
Practice Address - Street 1:BO MONACILLO
Practice Address - Street 2:CARRETERA #22, PASEO DR. JOSE C. BARBOSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14889208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH96582Medicare UPIN
PR21892Medicare ID - Type Unspecified