Provider Demographics
NPI:1699463471
Name:SOSA, JUAN JOSE SR (MD MPH)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:SOSA
Suffix:SR
Gender:M
Credentials:MD MPH
Other - Prefix:DR
Other - First Name:JUAN
Other - Middle Name:JOSE
Other - Last Name:SOSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JUAN J SOSA MD
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0586
Mailing Address - Country:US
Mailing Address - Phone:787-965-2040
Mailing Address - Fax:
Practice Address - Street 1:PASEO DEL PLATA SHOPPING VILLAGE
Practice Address - Street 2:604 AVE. JOSE EFROM #50
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-0586
Practice Address - Country:US
Practice Address - Phone:787-965-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR976-P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical