MEDICARE: DR. JOSE R ALEMAR ULLOA

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	207V00000X	Obstetrics & Gynecology Physician	10327	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	601337	OTHER		MEDICARE Y MUCHO MAS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	6230074	OTHER	HUMANA
2	4010-5	OTHER	PROSSAM
4	060564	OTHER	LA CRUZ AZUL DE PR
5	209400	OTHER	PREFERRED HEALTH
6	8-2812AL	OTHER	TRIPLE S

General Provider Information

NPI Number	:	1205903655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE R ALEMAR ULLOA

Provider Business Mailing Address
First Line	:	PO BOX 97
Second Line	:
City	:	SABANA GARNDE
State	:	PR
Zip	:	00637-0097
Country	:	US
Telephone Number	:	787-254-5009
Fax Number	:	787-899-4444

Provider Business Practice Location Address
First Line	:	#38 SANTOS ORTIZ AVE
Second Line	:	SAN JOSE PLAZA SUITE 104
City	:	CABO ROJO
State	:	PR
Zip	:	00623-4217
Country	:	US
Telephone Number	:	787-254-5009
Fax Number	:	787-899-4444

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	10/11/2010

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Directions to “ DR. JOSE R ALEMAR ULLOA ” Practice Location

Language	Start Address	Practice Location

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