Healthcare Provider Details

I. General information

NPI: 1093819112
Provider Name (Legal Business Name): JAN PIERRE ZEGARRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/06/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO BUCARE URB BUCARE, CALLE TURQUESA 2050
GUAYNABO PR
00969
US

IV. Provider business mailing address

PO BOX 270-080
SAN JUAN PR
00928-2780
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-5034
  • Fax:
Mailing address:
  • Phone: 787-763-5670
  • Fax: 787-753-3584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number4763
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: