MEDICARE: JOSE M PALOU ABASOLO 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	2084P0800X	Psychiatry Physician	11379	PR
2	2085R0001X	Radiation Oncology Physician	11379	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	24458	OTHER	PR	MEDICARE INDIVIDUAL NUMBER

General Provider Information

NPI Number	:	1407897994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE M PALOU ABASOLO M.D.

Provider Business Mailing Address
First Line	:	140 AVE LAS CUMBRES
Second Line	:	GUAYNABO MEDICAL MALL OFIC 201
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5523
Country	:	US
Telephone Number	:	787-731-5785
Fax Number	:	787-287-2487

Provider Business Practice Location Address
First Line	:	140 AVE LAS CUMBRES
Second Line	:	140 AVE LAS CUMBRES OFIC 201
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5523
Country	:	US
Telephone Number	:	787-731-5785
Fax Number	:	787-287-2487

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/16/2014

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