Provider Demographics
NPI:1194779249
Name:SANABRIA, JOSE LUIS
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LUIS
Last Name:SANABRIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PLAZA DEL PARQUE
Mailing Address - Street 2:346
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3010
Mailing Address - Country:US
Mailing Address - Phone:787-283-4281
Mailing Address - Fax:787-760-5545
Practice Address - Street 1:CARR #181 KM 9.1 BO DOS BOCAS
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-760-5545
Practice Address - Fax:787-760-5545
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15752208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice