Healthcare Provider Details

I. General information

NPI: 1013927185
Provider Name (Legal Business Name): FRANCISCO J. LLULL D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2363 LAS AMERICAS AVE.
PONCE PR
00717-0776
US

IV. Provider business mailing address

UNIVERSITY ST. 2355
PONCE PR
00717-0706
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-0000
  • Fax: 787-841-0943
Mailing address:
  • Phone: 787-844-8475
  • Fax: 787-841-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDM-14794-2
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: