Healthcare Provider Details

I. General information

NPI: 1245370279
Provider Name (Legal Business Name): PEDRO JUAN CLAUDIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL UPR #3 STREET KM 8.3 65 INFANTERY AVE
CAROLINA PR
00984-6021
US

IV. Provider business mailing address

HC 1 BOX 5123
CANOVANAS PR
00729-9744
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax: 787-750-0215
Mailing address:
  • Phone: 787-256-7843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number14770
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: