Provider Demographics
NPI:1699799767
Name:AGUDO, MARIA JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JOSE
Last Name:AGUDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:436 VIA CAMPINA
Mailing Address - Street 2:HACIENDA SAN JOSE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3098
Mailing Address - Country:US
Mailing Address - Phone:787-469-7997
Mailing Address - Fax:787-653-2362
Practice Address - Street 1:436 VIA CAMPINA
Practice Address - Street 2:HACIENDA SAN JOSE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-3098
Practice Address - Country:US
Practice Address - Phone:787-313-6831
Practice Address - Fax:787-653-2362
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13387208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics