MEDICARE: CONSULTORIO MEDICO FIGUEROA,CSP

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1760491930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSULTORIO MEDICO FIGUEROA,CSP

Provider Business Mailing Address
First Line	:	243 CALLE PARIS PMB 1313
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00917-3632
Country	:	US
Telephone Number	:	787-759-6909
Fax Number	:	787-282-0884

Provider Business Practice Location Address
First Line	:	200 CALLE JUAN P DUARTE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00917-3602
Country	:	US
Telephone Number	:	787-759-6909
Fax Number	:	787-282-0884

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WIANDA LUZ FIGUEROA
Credential	:	M.D.
Telephone Number	:	787-759-6909

Provider Enumeration Date	:	08/06/2006
Last Update Date	:	08/22/2020

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