Provider Demographics
NPI:1245976240
Name:CORDERO-VILLARRUBIA, PAUL BRAYAN (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:BRAYAN
Last Name:CORDERO-VILLARRUBIA
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:RR 36 BOX 6088
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9552
Mailing Address - Country:US
Mailing Address - Phone:939-349-8472
Mailing Address - Fax:
Practice Address - Street 1:CARR 844 KM 3.8 CUPEY BAJO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9552
Practice Address - Country:US
Practice Address - Phone:939-349-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program