Healthcare Provider Details

I. General information

NPI: 1356847107
Provider Name (Legal Business Name): MIGUEL JAVIER ANZALOTA DEL TORO MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 AVE LAS CUMBRES PR 199 KM 1.3 SUITE 14
GUAYNABO PR
00971-4833
US

IV. Provider business mailing address

1353 AVE LUIS VIGOREAUX
GUAYNABO PR
00966-2715
US

V. Phone/Fax

Practice location:
  • Phone: 787-940-6688
  • Fax: 305-686-3585
Mailing address:
  • Phone: 787-940-6688
  • Fax: 305-686-3585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22639
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number22639
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: