Healthcare Provider Details

I. General information

NPI: 1609855790
Provider Name (Legal Business Name): JUAN A ESPIET MIRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JUAN A ESPIET MIRAY M.D.

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 AVE PONCE DE LEON NATIONAL PLAZA SUITE701
SAN JUAN PR
00917-3418
US

IV. Provider business mailing address

431 AVE PONCE DE LEON NATIONAL PLAZA SUITE701
SAN JUAN PR
00917-3418
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-3227
  • Fax: 787-766-3236
Mailing address:
  • Phone: 787-754-3227
  • Fax: 787-766-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number6033
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: