MEDICARE: DR. NESTOR R. FRONTERA-TACORONTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	14482	PR

General Provider Information

NPI Number	:	1043206246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NESTOR R. FRONTERA-TACORONTE MD

Provider Business Mailing Address
First Line	:	3201 PORTALES DEL MONTE
Second Line	:	COTTO LAUREL
City	:	PONCE
State	:	PR
Zip	:	00780-2033
Country	:	US
Telephone Number	:	787-410-1144
Fax Number	:	787-821-5828

Provider Business Practice Location Address
First Line	:	44 CALLE 25 DE JULIO
Second Line	:
City	:	GUANICA
State	:	PR
Zip	:	00653-2712
Country	:	US
Telephone Number	:	787-821-5828
Fax Number	:	787-821-5828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	02/23/2011

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