Individual
DR. JUAN C IBLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7737
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7737
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
204925
MA
Other
Enumeration date
03/17/2006
Last updated
08/20/2007
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