Healthcare Provider Details

I. General information

NPI: 1477476828
Provider Name (Legal Business Name): ANDRES CHUECOS INTERNO/MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR PR 506 KM 1 0 BO COTO LAUREL
PONCE PR
00780
US

IV. Provider business mailing address

CALLE GROSELLA CASA 1619
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-848-2100
  • Fax:
Mailing address:
  • Phone: 786-344-1347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17937-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: