Provider Demographics
NPI:1801092671
Name:LASA IMBERT, ARNALDO ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:ARNALDO
Middle Name:ENRIQUE
Last Name:LASA IMBERT
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:J15 AVE SAN PATRICIO
Mailing Address - Street 2:PORTALES DE SAN PATRICIO APT. 606
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-4505
Mailing Address - Country:US
Mailing Address - Phone:787-793-6540
Mailing Address - Fax:
Practice Address - Street 1:735 AVE PONCE DE LEON STE 605
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5028
Practice Address - Country:US
Practice Address - Phone:787-282-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17105207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine