Provider Demographics
NPI:1538225073
Name:JOSE F TROCHE TROCHE MD CSP
Entity type:Organization
Organization Name:JOSE F TROCHE TROCHE MD CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:TROCHE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-856-3320
Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-1128
Mailing Address - Country:US
Mailing Address - Phone:787-856-3320
Mailing Address - Fax:787-267-0592
Practice Address - Street 1:PROL 25 JULIO #12
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-3320
Practice Address - Fax:787-267-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6261208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26456Medicare ID - Type Unspecified
D08376Medicare UPIN