Healthcare Provider Details

I. General information

NPI: 1922001577
Provider Name (Legal Business Name): HUGO MONTES-CARDONA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 PONCE DE LEON AVE TORRE AUXILIO MUTUO SUITE 602
SAN JUAN PR
00917-5028
US

IV. Provider business mailing address

735 PONCE DE LEON AVE TORRE AUXILIO MUTUO SUITE 602
SAN JUAN PR
00917-5028
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-7998
  • Fax: 787-281-0931
Mailing address:
  • Phone: 787-764-7998
  • Fax: 787-281-0931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number3061
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: