Provider Demographics
NPI:1770791576
Name:LLADO DIAZ, VICTOR J (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:J
Last Name:LLADO DIAZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:374 CALLE RAFAEL LAMAR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2117
Mailing Address - Country:US
Mailing Address - Phone:787-759-7948
Mailing Address - Fax:787-759-9645
Practice Address - Street 1:374 CALLE RAFAEL LAMAR
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2117
Practice Address - Country:US
Practice Address - Phone:787-759-7948
Practice Address - Fax:787-759-9645
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2009-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR42292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry