Healthcare Provider Details

I. General information

NPI: 1376759860
Provider Name (Legal Business Name): LUIS ARMANDO FONT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 TORRE MEDICA SAN JORGE SAN JORGE STREET SUITE 206
SAN JUAN PR
00912
US

IV. Provider business mailing address

252 CALLE SAN JORGE SUITE 206
SAN JUAN PR
00912-3239
US

V. Phone/Fax

Practice location:
  • Phone: 787-999-9450
  • Fax:
Mailing address:
  • Phone: 787-999-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14353
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number14353
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: