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NPI Code Detail

MEDICARE: DR. FERNANDO VIZCARRONDO M.D.

MEDICARE: DR. FERNANDO VIZCARRONDO M.D.
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
1208600000XSurgery Physician6479PR

General Provider Information

NPI Number : 1336121425
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FERNANDO VIZCARRONDO M.D.
Provider Business Mailing Address
First Line : A7 CALLE HUCAR
Second Line : VILLA HUCAR
City : SAN JUAN
State : PR
Zip : 00926-6818
Country : US
Telephone Number : 787-754-0055
Fax Number : 787-754-0061
Provider Business Practice Location Address
First Line : 369 AVE DE DIEGO
Second Line : OF. 301 TORRE SAN FRANCISCO
City : SAN JUAN
State : PR
Zip : 00923-3003
Country : US
Telephone Number : 787-754-0055
Fax Number : 787-754-0061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 11/11/2013

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