Provider Demographics
NPI:1285694505
Name:ANGLERO ALFARO, JORGE G (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:G
Last Name:ANGLERO ALFARO
Suffix:
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:C20 CALLE ECLIPSE
Mailing Address - Street 2:REPARTO ANAIDA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2534
Mailing Address - Country:US
Mailing Address - Phone:787-447-6556
Mailing Address - Fax:
Practice Address - Street 1:2746 BLVD LUIS A FERRE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0300
Practice Address - Country:US
Practice Address - Phone:787-848-7604
Practice Address - Fax:787-848-7604
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG37140Medicare UPIN
PRFB695AMedicare PIN