Basic Information
Provider Information
NPI: 1659355246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARROYO
FirstName: JOSE
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1077
Address2:  
City: AIBONITO
State: PR
PostalCode: 007051077
CountryCode: US
TelephoneNumber: 7877354887
FaxNumber: 7877354887
Practice Location
Address1: BALDORIOTY 156 N AIBONITO
Address2:  
City: AIBONITO
State: PR
PostalCode: 00705
CountryCode: US
TelephoneNumber: 7877354887
FaxNumber: 7877354887
Other Information
ProviderEnumerationDate: 12/06/2005
LastUpdateDate: 12/13/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171100000X328PRN Other Service ProvidersAcupuncturist 
208D00000X8196PRY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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