Provider Demographics
NPI:1831294271
Name:NAVEDO FRONTERA, ANGEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:M
Last Name:NAVEDO FRONTERA
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:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690
Mailing Address - Country:US
Mailing Address - Phone:787-890-3235
Mailing Address - Fax:787-890-5467
Practice Address - Street 1:CALLE COMERCIO 486
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:PR
Practice Address - Zip Code:00690
Practice Address - Country:US
Practice Address - Phone:787-890-3235
Practice Address - Fax:787-890-5467
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5524208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty