Healthcare Provider Details

I. General information

NPI: 1932264090
Provider Name (Legal Business Name): JANINE LABORDE SANFIORENZO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. DOMENECH 400, SUITE 505 LAS AMERICAS PROFESSIONAL CENTER
SAN JUAN PR
00918-5000
US

IV. Provider business mailing address

AVE. DOMENECH 400, SUITE 505 LAS AMERICAS PROFESSIONAL CENTER
SAN JUAN PR
00918-5000
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-8266
  • Fax: 787-753-8266
Mailing address:
  • Phone: 787-753-8266
  • Fax: 787-753-8266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14603
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number14603
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number14603
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: