Healthcare Provider Details

I. General information

NPI: 1346212388
Provider Name (Legal Business Name): LUIS E LANDESTOY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AL5 VIA ELENA VILLA FONTANA
CAROLINA PR
00983-3901
US

IV. Provider business mailing address

A L 5 VIA ELENA VILLA FONTANA
CAROLINA PR
00983-3901
US

V. Phone/Fax

Practice location:
  • Phone: 787-762-9424
  • Fax:
Mailing address:
  • Phone: 787-762-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number7570
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: