Healthcare Provider Details

I. General information

NPI: 1548241011
Provider Name (Legal Business Name): JOSE A BARCELO FRONTERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1462 CALLE PROF AUGUSTO RODRIGUEZ
SAN JUAN PR
00909-2145
US

IV. Provider business mailing address

PO BOX 363887
SAN JUAN PR
00936-3887
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-6555
  • Fax: 787-268-0076
Mailing address:
  • Phone: 787-727-6060
  • Fax: 787-268-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number8202
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: