Provider Demographics
NPI:1912129693
Name:SAUNDERS-MALAVE, ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:SAUNDERS-MALAVE
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:E-9 CAMINO DE LAS PALMAS
Mailing Address - Street 2:URB PASEO DEL PRADO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-233-8700
Mailing Address - Fax:
Practice Address - Street 1:DOCTOR CENTER'S HOSPITAL DE BAYAMON
Practice Address - Street 2:DEPT DE RADIOLOGIA INTERVENCIONAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-622-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0549362085R0202X
SC297952085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC297958Medicaid
PR17,526OtherLICENCIA DE MEDICO
SC297958Medicaid