Healthcare Provider Details

I. General information

NPI: 1245224278
Provider Name (Legal Business Name): PEDRO J TORT-SAADE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 11/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PROFESSIONAL HOSPITAL CARR.199 KM. 1.2
GUAYNABO PR
00969
US

IV. Provider business mailing address

138 AVE WINSTON CHURCHILL PMB 550
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-773-0023
  • Fax:
Mailing address:
  • Phone: 787-773-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number13586
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: