MEDICARE: DR. PEDRO A VALENTIN BUSCAMPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208D00000X	General Practice Physician	22054	PR

General Provider Information

NPI Number	:	1164086823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO A VALENTIN BUSCAMPER MD

Provider Business Mailing Address
First Line	:	RR 36 BOX 8165
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9963
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR 843 KM 9.3
Second Line	:	CAMINOS LOS APONTE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0001
Country	:	US
Telephone Number	:	787-525-4477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	02/03/2021

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