Healthcare Provider Details

I. General information

NPI: 1669385878
Provider Name (Legal Business Name): FONTMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLZ
BAYAMON PR
00959-7200
US

IV. Provider business mailing address

C61 CALLE 2
SAN JUAN PR
00926-6498
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-8181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIO FONT GARCIA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-509-3009