Healthcare Provider Details

I. General information

NPI: 1285296731
Provider Name (Legal Business Name): ANGEL JOSE FIGUEROA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 07/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO ROMERO CARR 149 KM 62.6
VILLALBA PR
00766
US

IV. Provider business mailing address

HC 2 BOX 5028
VILLALBA PR
00766-9719
US

V. Phone/Fax

Practice location:
  • Phone: 787-217-3705
  • Fax:
Mailing address:
  • Phone: 787-217-3705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number21501
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14830I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: