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General NPI Number Information
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NPI Number | 1952515694
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Entity Type | Individual
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Provider Name | WANDA ANGELICA JORGE-BARRETO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 54 BOULEVARD DE LA MEDIA LUNA COND. JARDINES DEL PARQUE APT. 1504
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City | CAROLINA
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State | PR
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Zip | 00987-4933
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Country | US
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Telephone | 787-757-2979
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Fax |
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Provider Business Mailing Address
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Address Line | 54 BOULEVARD DE LA MEDIA LUNA COND. JARDINES DEL PARQUE APT. 1504
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City | CAROLINA
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State | PR
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Zip | 00987-4933
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Country | US
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Telephone | 787-379-5933
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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 | 9603
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License Number State | PR
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