Provider Demographics
NPI:1265413439
Name:ALVAREZ PONT, ANTOLIN J (MD)
Entity type:Individual
Prefix:DR
First Name:ANTOLIN
Middle Name:J
Last Name:ALVAREZ PONT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:39 CALLE BROMELIA
Mailing Address - Street 2:PARQUE DE BUCARE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5103
Mailing Address - Country:US
Mailing Address - Phone:787-728-7390
Mailing Address - Fax:787-728-9686
Practice Address - Street 1:1801 AVE PONCE DE LEON
Practice Address - Street 2:SANTURCE MEDICAL MALL STE. 213
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-1900
Practice Address - Country:US
Practice Address - Phone:787-728-7390
Practice Address - Fax:787-728-9686
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2010-05-12
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Provider Licenses
StateLicense IDTaxonomies
PR6028207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE30428Medicare UPIN