Provider Demographics
NPI:1588615058
Name:BACO, FRANCIS P (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:P
Last Name:BACO
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 1:10 CASIA ST.
Mailing Address - Street 2:MAIL STOP 111-MEDICAL SERVICE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-641-3669
Mailing Address - Fax:
Practice Address - Street 1:COND PARK ROYAL
Practice Address - Street 2:D-13 PARKSIDE 6 APT 401
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3331
Practice Address - Country:US
Practice Address - Phone:787-641-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7301207R00000X, 207RE0101X, 208M00000X
MA71955207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08496Medicare ID - Type Unspecified