Basic Information
| Provider Information | |||||||||
| NPI: | 1952953598 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LARRAURI DEL VALLE | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | JESUS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1883 | ||||||||
| Address2: | |||||||||
| City: | COAMO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007691883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874798167 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL ONCOLOGICO | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009350001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877634149 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2019 | ||||||||
| LastUpdateDate: | 07/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 15134 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.