Healthcare Provider Details

I. General information

NPI: 1215058433
Provider Name (Legal Business Name): JOSE ALBERRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B7 CALLE SANTA CRUZ
BAYAMON PR
00961-6902
US

IV. Provider business mailing address

GG26 CALLE 19 AALTURAS DE FLAMBOYAN
BAYAMON PR
00959-8066
US

V. Phone/Fax

Practice location:
  • Phone: 787-786-1325
  • Fax:
Mailing address:
  • Phone: 787-269-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15840
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: