Provider Demographics
NPI:1902067945
Name:DRES. PEGUERO E IGUINA
Entity Type:Organization
Organization Name:DRES. PEGUERO E IGUINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA DEL
Authorized Official - Middle Name:CARMEN
Authorized Official - Last Name:IGUINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-845-2190
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0517
Mailing Address - Country:US
Mailing Address - Phone:787-845-2190
Mailing Address - Fax:787-845-2254
Practice Address - Street 1:25 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2618
Practice Address - Country:US
Practice Address - Phone:787-845-2190
Practice Address - Fax:787-845-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8244208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty