Healthcare Provider Details

I. General information

NPI: 1871616631
Provider Name (Legal Business Name): JULIO C ZUNIGA HIDALGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB DORADO DEL MAR N 11 CALLE LAS OLAS
DORADO PR
00646
US

IV. Provider business mailing address

URB DORADO DEL MAR N 11 CALLE LAS OLAS
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-538-7690
  • Fax:
Mailing address:
  • Phone: 787-538-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15903
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: