MEDICARE: BIANCA S PUJOL ANGOMAS M.D.

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	208D00000X	General Practice Physician	10897	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10897	OTHER	PR	LICENSE

General Provider Information

NPI Number	:	1386641538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA S PUJOL ANGOMAS M.D.

Provider Business Mailing Address
First Line	:	116 CALLE CORAL
Second Line	:	PARQUE DE ISLA VERDE
City	:	CAROLINA
State	:	PR
Zip	:	00979-1364
Country	:	US
Telephone Number	:	787-374-4109
Fax Number	:	787-253-1428

Provider Business Practice Location Address
First Line	:	312 AVE DE DIEGO
Second Line	:	TORRE MUSEO BLDG
City	:	SANTURCE
State	:	PR
Zip	:	00909-1756
Country	:	US
Telephone Number	:	787-480-3702
Fax Number	:	787-724-4057

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	12/21/2016

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