Healthcare Provider Details

I. General information

NPI: 1235211178
Provider Name (Legal Business Name): ALEXANDER LEE SEGAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 AVE. ARTERIAL HOSTOS, CAPITAL CENTER SUITE 205
HATO REY PR
00918
US

IV. Provider business mailing address

29 AZUCENA ST. URB RIO PIEDRAS VALLEY URB. RIO PIEDRAS VALLEY
RIO PIEDRAS PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-413-0297
  • Fax: 787-753-7527
Mailing address:
  • Phone: 787-413-0297
  • Fax: 787-753-7592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number15692
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: