Provider Demographics
NPI:1841385861
Name:FRONTERA, ERNESTO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:A
Last Name: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:PLAZA SUCHVILLE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-273-1165
Mailing Address - Fax:
Practice Address - Street 1:12 PATRICIA, SUSAN COURT CHALETS
Practice Address - Street 2:TINTILLO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-273-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR79902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0029858Medicare ID - Type Unspecified