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General NPI Number Information
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NPI Number | 1386862761
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Entity Type | Individual
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Provider Name | NITZA FONTANEZ
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1324 CALLE CANADA ANTIGUO HOSPITAL VETERANO PUERTO NUEVO
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City | SAN JUAN
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State | PR
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Zip | 00920-3860
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Country | US
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Telephone | 787-793-1554
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 147 PO BOX 607071
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City | BAYAMON
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State | PR
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Zip | 00960-7071
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 19859
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License Number State | PR
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