Provider Demographics
NPI:1952335481
Name:LABOY ZENGOTITA, ADAIR (MD)
Entity type:Individual
Prefix:DR
First Name:ADAIR
Middle Name:
Last Name:LABOY ZENGOTITA
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 19897
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-1897
Mailing Address - Country:US
Mailing Address - Phone:787-507-3607
Mailing Address - Fax:787-765-3304
Practice Address - Street 1:1503 COND ASIA
Practice Address - Street 2:SUITE 402
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-507-3607
Practice Address - Fax:787-765-3304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9074207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084226Medicare ID - Type UnspecifiedPERSONAL
G41534Medicare UPIN
PR0082222GMedicare ID - Type UnspecifiedGRUPAL