=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710845334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FMO HEALTH COLLECTIVE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2026
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 CARR 848 INT 181 EDIF CENTRO 4 SUITE 205
-----------------------------------------------------
City | TRUJILLO ALTO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00976-3168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-760-1632
-----------------------------------------------------
Fax | 787-760-1632
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | RE8 VIA PIEDRAS
-----------------------------------------------------
City | TRUJILLO ALTO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00976-6300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-642-6596
-----------------------------------------------------
Fax | 787-760-1632
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FRANCISCO R MARTE-OQUENDO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 787-642-6596
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------