Basic Information
| Provider Information | |||||||||
| NPI: | 1710291992 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABDUL-HADI | ||||||||
| FirstName: | ANWAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ABDUL-HADI MARTINEZ | ||||||||
| OtherFirstName: | ANWAR | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 260086 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009262617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876213270 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2DO PISO CLINICA ESPECIALIDADES PEDIATRICAS | ||||||||
| Address2: | MANATI MEDICAL CENTER, CALLE HERNANDEZ CARRION | ||||||||
| City: | MANATI | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876213270 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2010 | ||||||||
| LastUpdateDate: | 08/02/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 18837 | PR | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 036143985 | IL | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0120X | 33263 | OK | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 208D00000X | 18837 | PR | N | Allopathic & Osteopathic Physicians | General Practice | 2086S0120X | 18837 | PR | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.