Basic Information
| Provider Information | |||||||||
| NPI: | 1578560702 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERTRAN PASARELL | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PMB 343 35 J.C.BORBON 67 | ||||||||
| Address2: | |||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009695375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877891923 | ||||||||
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| Practice Location | |||||||||
| Address1: | AVE. PONCE DE LEON STOP 37 1/2 | ||||||||
| Address2: | AUXILIO MUTUO HOSPITAL | ||||||||
| City: | HATO REY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2005 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 11571 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.