Fajardo Medical Practice

NPI #1134319320 in Fajardo, Puerto Rico

Provider Information

NPI Number: 1134319320
Entity Type: Organization
Organization Name: Fajardo Medical Practice
Subpart: Yes (part of a larger organization)
Parent Organization: FAJARDO MEDICAL PRACTICE
Primary Specialty: General Practice
Enumeration Date: Jul 25, 2007
Last Updated: Jul 25, 2007

Practice Location

Address: I23 CALLE PRINCIPAL
Address 2: URB BARALT
City: Fajardo
State: Puerto Rico
ZIP Code: 00738-3772
Phone: (787) 863-7646

Authorized Official

Name: DR. AGAPITO FONTANEZ NIEVES, M.D.
Title: PRESIDENTE
Phone: (787) 863-7646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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