Provider Demographics
NPI:1144245432
Name:FUMERO, JOSE O
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:O
Last Name:FUMERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CALLE REY FERNANDO
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2619
Mailing Address - Country:US
Mailing Address - Phone:787-813-3411
Mailing Address - Fax:
Practice Address - Street 1:104 CALLE REY FERNANDO
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2619
Practice Address - Country:US
Practice Address - Phone:787-464-3411
Practice Address - Fax:787-813-3411
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR147112085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology