Healthcare Provider Details

I. General information

NPI: 1790746550
Provider Name (Legal Business Name): FRANCISCO LAFONTAINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANATI PLZ URBANIZACION ATENAS
MANATI PR
00674-6204
US

IV. Provider business mailing address

415 CALLE TULANE ESTANCIAS TORTUGUERO
VEGA BAJA PR
00693-3643
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3700
  • Fax: 787-621-3710
Mailing address:
  • Phone: 787-621-3700
  • Fax: 787-621-3710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8074
License Number StatePR

VII. Legacy identifiers

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

# 1
Identifier4873
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerUNITED
# 2
Identifier28074
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCIGNA
# 3
Identifier81626
Identifier TypeMEDICAID
Identifier StatePR
Identifier Issuer
# 4
Identifier7080057
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerHUMANA
# 5
Identifier2405
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerPREFERED MEDICARE CHOICE
# 6
Identifier8674
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerIMC
# 7
Identifier067684
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCRUZ AZUL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: