Healthcare Provider Details

I. General information

NPI: 1194801522
Provider Name (Legal Business Name): WILLIAM DE LA PAZ M.D..
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 AVE MUNOZ RIVERA SUITE 3220
SAN JUAN PR
00918-4257
US

IV. Provider business mailing address

5 CALLE 1A ALTURAS BERWIND
SAN JUAN PR
00924-2465
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-3450
  • Fax: 787-767-3450
Mailing address:
  • Phone: 787-257-1459
  • Fax: 787-757-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number7818
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: