Individual
JOSE ANTONIO PACHECO SUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1511 AVE PONCE DE LEON, APT 176, SAN JUAN, PR 00909-5001
(952) 595-1100
(612) 294-4903
Mailing address
1511 AVE PONCE DE LEON, CIUDADELA APT # 176, SAN JUAN, PR 00909-5001
(787) 502-8020
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
018127
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EQ104Y
MEDICARE PTAN
PR
Enumeration date
01/24/2008
Last updated
10/29/2018
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