MEDICARE: DR. JOSE A ZAYAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	10899	PR

General Provider Information

NPI Number	:	1962476473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE A ZAYAS M.D.

Provider Business Mailing Address
First Line	:	369 CALLE DE DIEGO
Second Line	:	404
City	:	SAN JUAN
State	:	PR
Zip	:	00923-3003
Country	:	US
Telephone Number	:	787-282-8112
Fax Number	:	787-274-1929

Provider Business Practice Location Address
First Line	:	COND DE DIEGO
Second Line	:	404
City	:	SAN JUAN
State	:	PR
Zip	:	00923-3001
Country	:	US
Telephone Number	:	787-282-8112
Fax Number	:	787-274-1929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	02/09/2016

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