Individual
JOSE ANTONIO MIRO CEBALLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1003 CALLE ACAPULCO, SAN JUAN, PR 00920-4054
(787) 749-0849
(787) 749-9623
Mailing address
PO BOX 367056, SAN JUAN, PR 00936-7056
(787) 749-0849
(787) 749-9623
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
6979
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29600MI
SSS PROVIDER NUMBER
PR
Enumeration date
04/16/2007
Last updated
07/09/2007
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