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General NPI Number Information
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NPI Number | 1538791736
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Entity Type | Individual
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Provider Name | VICTOR REUBEN BAEZ DE JESUS MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2020 AVE BORINQUEN
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City | SAN JUAN
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State | PR
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Zip | 00915-3822
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Country | US
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Telephone | 787-268-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 373 SEC MELENDEZ
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City | CIDRA
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State | PR
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Zip | 00739-2104
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Country | US
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Telephone | 786-520-8545
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24441
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License Number State | PR
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