Provider Demographics
NPI:1982696688
Name:FIGUEROA, JOSE SEBASTIAN (DO)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:SEBASTIAN
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4104
Mailing Address - Country:US
Mailing Address - Phone:515-271-1722
Mailing Address - Fax:515-271-1539
Practice Address - Street 1:3200 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-4104
Practice Address - Country:US
Practice Address - Phone:515-271-1722
Practice Address - Fax:515-271-1697
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03436208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0258012Medicaid
IA250013449OtherRR MEDICARE
IA0258012Medicaid
IA250013449OtherRR MEDICARE