Healthcare Provider Details

I. General information

NPI: 1235129438
Provider Name (Legal Business Name): MAITE A URQUIA ARAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE EL COMANDANTE PQ-24, 3RA EXT COUNTRY CLUB
CAROLINA PR
00982
US

IV. Provider business mailing address

URB PARK GARDENS CALLE ACADIA P1-15
SAN JUAN PR
00920
US

V. Phone/Fax

Practice location:
  • Phone: 787-409-1765
  • Fax: 787-276-3366
Mailing address:
  • Phone: 787-409-1765
  • Fax: 787-276-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number14221
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: