Provider Demographics
NPI:1114122199
Name:FRANCO, JOSE ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:118 CALLE CHARDON
Mailing Address - Street 2:QUANTUM METROCENTER II BOX 095
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-466-3211
Mailing Address - Fax:
Practice Address - Street 1:B7 CALLE 1
Practice Address - Street 2:URB FAIRVIEW
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5447
Practice Address - Country:US
Practice Address - Phone:787-466-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR178702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR17870OtherJUNTA DE LICENCIAMENTO Y DISCIPLINA MEDICA