Provider Demographics
NPI:1871534990
Name:TIRADO, NESTOR C (MD)
Entity type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:C
Last Name:TIRADO
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 1:80 CALLE KINGS CT
Mailing Address - Street 2:APT. 203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1636
Mailing Address - Country:US
Mailing Address - Phone:787-922-1512
Mailing Address - Fax:
Practice Address - Street 1:80 CALLE KINGS CT APT 203
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1636
Practice Address - Country:US
Practice Address - Phone:787-922-1512
Practice Address - Fax:787-726-1563
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine