Provider Demographics
NPI:1336158468
Name:MAGRANER-SUAREZ, MIGUEL A (MD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:MAGRANER-SUAREZ
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:HOCIENDAS DEL MONTE PASEO LA CONSTANCIA
Mailing Address - Street 2:#5019
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2368
Mailing Address - Country:US
Mailing Address - Phone:787-840-3128
Mailing Address - Fax:787-840-3623
Practice Address - Street 1:2225 EDIFICIO PARRA SUITE 304
Practice Address - Street 2:PONCE BU PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1320
Practice Address - Country:US
Practice Address - Phone:787-840-3128
Practice Address - Fax:787-840-3623
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E01280Medicare UPIN
80430Medicare ID - Type Unspecified