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General NPI Number Information
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NPI Number | 1205092418
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Entity Type | Organization
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Legal Business Name | ARIEL CHACON BALADO, MD, C.S.P.
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 576 AVE. CESAR GONZALEZ DORAL BANK CENTER SUITE 508
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-504-9848
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Fax |
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Provider Business Mailing Address
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Address Line | 138 AVE WINSTON CHURCHILL PMB 560
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City | SAN JUAN
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State | PR
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Zip | 00926-6023
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Country | US
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Telephone | 787-504-9848
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARIEL CHACON BALADO
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Credential | M.D.
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Telephone | 787-504-9848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 16682
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License Number State | PR
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