Provider Demographics
NPI:1053533067
Name:ALMODOVAR MARCHANY, LUIS A (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:ALMODOVAR MARCHANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 793
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-849-3055
Mailing Address - Fax:787-849-3351
Practice Address - Street 1:AVE LUIS MUNOZ MARIN #6
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-3055
Practice Address - Fax:787-849-3351
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5306208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
26662Medicare ID - Type Unspecified
E31462Medicare UPIN