Provider Demographics
NPI:1386754885
Name:PALES AGUILO, JOAQUIN RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:RAFAEL
Last Name:PALES AGUILO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOAQUIN
Other - Middle Name:R
Other - Last Name:PALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0418
Mailing Address - Country:US
Mailing Address - Phone:787-864-4980
Mailing Address - Fax:787-864-4980
Practice Address - Street 1:AVE. LOS VETERANOS #3
Practice Address - Street 2:GUAYAMA MEDICAL CENTER
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-4980
Practice Address - Fax:787-864-4980
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7217207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C77625Medicare UPIN
PR0028559Medicare PIN
PRC77625Medicare UPIN