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NPI Code Detail

MEDICARE: DR. EMILIO FENTANES M.D.

MEDICARE: DR. EMILIO FENTANES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianMD17066HI
22085R0202XDiagnostic Radiology Physician315357NY

General Provider Information

NPI Number : 1093009276
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILIO FENTANES M.D.
Provider Business Mailing Address
First Line : PO BOX 932163
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0008
Country : US
Telephone Number : 610-477-6147
Fax Number : 302-440-5532
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : FORT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-539-8414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2011
Last Update Date : 12/10/2025

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