MEDICARE: JURGEN ANTHONY THIAS 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	208D00000X	General Practice Physician	024583	PR

General Provider Information

NPI Number	:	1528695616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JURGEN ANTHONY THIAS MD

Provider Business Mailing Address
First Line	:	PO BOX 6447
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-6447
Country	:	US
Telephone Number	:	787-940-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 CALLE SERGIO CUEVAS BUSTAMANTE ESQ. AVE DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918
Country	:	US
Telephone Number	:	787-758-8383
Fax Number	:

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

Provider Enumeration Date	:	03/26/2020
Last Update Date	:	03/17/2026

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