Healthcare Provider Details

I. General information

NPI: 1659422095
Provider Name (Legal Business Name): FRANZ EDWARD STIEHL BETANCOURT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CALLE JUAN P DUARTE
HATO REY PR
00917-3602
US

IV. Provider business mailing address

1708 CALLE SAN JULIAN SAGRADO CORAZON
SAN JUAN PR
00926-4269
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-6909
  • Fax: 787-282-0884
Mailing address:
  • Phone: 787-646-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12405
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: