Provider Demographics
NPI:1598829822
Name:ESTRADA FERNANDEZ, FRANCISCO MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:MANUEL
Last Name:ESTRADA FERNANDEZ
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 1:40 CALLE GARDENIA
Mailing Address - Street 2:EL CONDADO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-2466
Mailing Address - Country:US
Mailing Address - Phone:787-529-1718
Mailing Address - Fax:
Practice Address - Street 1:40 CALLE GARDENIA
Practice Address - Street 2:EL CONDADO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2466
Practice Address - Country:US
Practice Address - Phone:787-529-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10074208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82306Medicare ID - Type Unspecified
PRF99356Medicare UPIN