Healthcare Provider Details

I. General information

NPI: 1366563488
Provider Name (Legal Business Name): JOSE FRANCISCO CAMPOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF. SPRINT METRO OFFICE PARK CALLE 1 LOTE 18 SUITE 400
GUAYNABO PR
00968
US

IV. Provider business mailing address

PO BOX 9172
CAROLINA PR
00988-9172
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-3875
  • Fax:
Mailing address:
  • Phone: 787-360-8952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number7234
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: