Healthcare Provider Details

I. General information

NPI: 1205419439
Provider Name (Legal Business Name): ANGELICA MILADY FUENTES ARMESTO MD, DABFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 60327
BAYAMON PR
00960-6032
US

IV. Provider business mailing address

PO BOX 60327
BAYAMON PR
00960-6032
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-3001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number22906
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22906
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: