Healthcare Provider Details

I. General information

NPI: 1194176578
Provider Name (Legal Business Name): DAVID BEATON COMULADA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID BEATON COMULADA MD

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY DISTRICT HOSPITAL BO , MONACILLOS
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

1887 CALLE FRANCISCO QUINDOS
SAN JUAN PR
00926-7732
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax:
Mailing address:
  • Phone: 787-949-9532
  • Fax: 347-577-4596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number23744
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number23744
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number23744
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: