MEDICARE: DR. JOSE ANTONIO PIETRI 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	171100000X	Acupuncturist	466	PR
2	208D00000X	General Practice Physician	14885	PR

General Provider Information

NPI Number	:	1285637629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE ANTONIO PIETRI MD

Provider Business Mailing Address
First Line	:	PO BOX 1515
Second Line	:
City	:	AIBONITO
State	:	PR
Zip	:	00705-1515
Country	:	US
Telephone Number	:	787-991-1560
Fax Number	:	787-991-1560

Provider Business Practice Location Address
First Line	:	102 RAMON FLORES ST.
Second Line	:
City	:	AIBONITO
State	:	PR
Zip	:	00705-3716
Country	:	US
Telephone Number	:	787-991-1560
Fax Number	:	787-991-1560

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/01/2012

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