Provider Demographics
NPI:1215993373
Name:NOYA MONAGAS, JORGE ARTURO SR (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ARTURO
Last Name:NOYA MONAGAS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40432
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00940-0432
Mailing Address - Country:US
Mailing Address - Phone:787-723-2168
Mailing Address - Fax:787-725-0210
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:SUITE # 404
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-723-2168
Practice Address - Fax:787-725-0210
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5741174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08704Medicare UPIN
PR97224Medicare ID - Type Unspecified