Provider Demographics
NPI:1811966633
Name:MONTILLA ADSUAR, JULIETA (MD)
Entity type:Individual
Prefix:DR
First Name:JULIETA
Middle Name:
Last Name:MONTILLA ADSUAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIETA
Other - Middle Name:
Other - Last Name:MONTILLA ADSUAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:164 URB LA SERRANIA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1806
Mailing Address - Country:US
Mailing Address - Phone:787-765-0680
Mailing Address - Fax:
Practice Address - Street 1:531 CALLE SERGIO CUEVAS
Practice Address - Street 2:URBANIZACION PARQUE CENTRAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2642
Practice Address - Country:US
Practice Address - Phone:787-765-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20641Medicare ID - Type UnspecifiedNUMERO DE PROVEEDOR MEDIC