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General NPI Number Information
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NPI Number | 1447255021
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Entity Type | Individual
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Provider Name | FERNANDO L LONGO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | TORRE SAN PABLO SUITE 201 #68 CALLE SANTA CRUZ
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City | BAYAMON
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State | PR
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Zip | 00961-7038
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Country | US
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Telephone | 787-786-3358
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Fax | 787-787-8183
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Provider Business Mailing Address
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Address Line | TORRE SAN PABLO SUITE 201 #68 CALLE SANTA CRUZ
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City | BAYAMON
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State | PR
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Zip | 00961-7038
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Country | US
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Telephone | 787-786-3358
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Fax | 787-787-8183
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 3082
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License Number State | PR
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