Provider Demographics
NPI:1528285202
Name:ALLENDE, NESTOR R
Entity type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:R
Last Name:ALLENDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. 1
Mailing Address - Street 2:D-5 PASEO MAYOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-397-3064
Mailing Address - Fax:787-751-7947
Practice Address - Street 1:369 CALLE DE DIEGO
Practice Address - Street 2:TORRE SAN FRANCISCO SUITE 501
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-751-4476
Practice Address - Fax:787-751-7947
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08785Medicare UPIN
PR0098625Medicare ID - Type Unspecified