Healthcare Provider Details

I. General information

NPI: 1720293855
Provider Name (Legal Business Name): FRANCISCO JUAN FRONTERA-ENSENAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 CORAZONES AVE. CORP. FONDO SEGURO DEL ESTADO
MAYAGUEZ PR
00681-0000
US

IV. Provider business mailing address

PO BOX 2892
MAYAGUEZ PR
00681-2892
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-8700
  • Fax:
Mailing address:
  • Phone: 787-833-8391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number9713
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: