Healthcare Provider Details

I. General information

NPI: 1417606500
Provider Name (Legal Business Name): NATASHA LIZETTE FRONTERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. SANTA MARIA 2 CALLE AZUCENA
SAN JUAN PR
00927-6731
US

IV. Provider business mailing address

URB. SANTA MARIA 2 CALLE AZUCENA
SAN JUAN PR
00927-6731
US

V. Phone/Fax

Practice location:
  • Phone: 787-248-0244
  • Fax:
Mailing address:
  • Phone: 787-248-0244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number24922
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: