Healthcare Provider Details

I. General information

NPI: 1528277290
Provider Name (Legal Business Name): RENE ANTONIO FERNANDEZ-PELEGRINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 CALLE DE DIEGO TORRE SAN FRANCISCO SUITE 606
SAN JUAN PR
00923-3003
US

IV. Provider business mailing address

369 CALLE DE DIEGO TORRE SAN FRANCISCO SUITE 606
SAN JUAN PR
00923-3003
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-2773
  • Fax: 787-763-2773
Mailing address:
  • Phone: 787-763-2773
  • Fax: 787-763-2773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number10054
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: