Provider Demographics
NPI:1225625247
Name:FONT BOCANEGRA, LUIS FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:FRANCISCO
Last Name:FONT BOCANEGRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 9 BOX 11939
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9319
Mailing Address - Country:US
Mailing Address - Phone:775-409-9961
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE VILLA ISABEL
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-8600
Practice Address - Country:US
Practice Address - Phone:787-951-2964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22643208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice