Provider Demographics
NPI:1386698405
Name:TAMPE-MORENO, CRISTIAN R (MD)
Entity type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:R
Last Name:TAMPE-MORENO
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 1:778 VALLE DE LAJAS
Mailing Address - Street 2:LOS CAMPOS DE MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7033
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:787-641-9501
Practice Address - Street 1:778 VALLE DE LAJAS
Practice Address - Street 2:LOS CAMPOS DE MONTEHIEDRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7033
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-9501
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13742207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084351Medicare ID - Type Unspecified
PRH48538Medicare UPIN