Provider Demographics
NPI:1881602035
Name:SORRENTINO, JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:SORRENTINO
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:G5 CALLE RUISENOR
Mailing Address - Street 2:TIERRALTA III
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3348
Mailing Address - Country:US
Mailing Address - Phone:787-731-2482
Mailing Address - Fax:
Practice Address - Street 1:G5 CALLE RUISENOR
Practice Address - Street 2:TIERRALTA III
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3348
Practice Address - Country:US
Practice Address - Phone:787-731-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10632208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery