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General NPI Number Information
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NPI Number | 1639537806
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Entity Type | Individual
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Provider Name | JOSE ROBERTO ALLENDE MOURE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | A3 CALLE GARCIA DE LA NOCEDA VILLAS DE RIO GRANDE
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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 | 787-636-6656
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Fax | 787-809-1144
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Provider Business Mailing Address
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Address Line | PO BOX 878
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City | RIO GRANDE
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State | PR
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Zip | 00745-0878
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Country | US
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Telephone | 787-636-6656
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Fax | 787-809-1144
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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 | 19778
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License Number State | PR
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