Provider Demographics
NPI:1912984469
Name:SEGARRA, ENRIQUE (MD)
Entity Type:Individual
Prefix:MR
First Name:ENRIQUE
Middle Name:
Last Name:SEGARRA
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:PO BOX 79111
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9111
Mailing Address - Country:US
Mailing Address - Phone:787-791-1087
Mailing Address - Fax:787-791-1087
Practice Address - Street 1:HOSPITAL AUXILIO MUTUO (ER)
Practice Address - Street 2:AVE PONCE DE LEON PARADA 37 1/2
Practice Address - City:ATO REY
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-758-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5438207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine