Healthcare Provider Details

I. General information

NPI: 1104802792
Provider Name (Legal Business Name): ALBERT A TITUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 05/02/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SUNNY ISLE STE 26B
CHRISTIANSTED VI
00820-4493
US

IV. Provider business mailing address

9086 PETERS REST
CHRISTIANSTED VI
00820-5617
US

V. Phone/Fax

Practice location:
  • Phone: 340-715-7779
  • Fax: 877-451-0296
Mailing address:
  • Phone: 340-715-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME80817
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1613
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: