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General NPI Number Information
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NPI Number | 1144021858
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Entity Type | Individual
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Provider Name | ADRIAN ALFONSO ALMODOVAR DIAZ
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Gender |
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | PO BOX 365067
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City | SAN JUAN
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State | PR
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Zip | 00936-5067
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Country | US
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Telephone | 787-758-2525
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Fax |
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Provider Business Mailing Address
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Address Line | CAMBALACHE 1, 101 CALLE CEDRO N26
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-510-7489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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