Provider Demographics
NPI:1922015411
Name:JA FAMILY CARE CENTER & ASSOCIATES, INC
Entity Type:Organization
Organization Name:JA FAMILY CARE CENTER & ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY MEDICINE DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:FONTANET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-846-7787
Mailing Address - Street 1:CAMINO DEL SOL II
Mailing Address - Street 2:METEORO AVENUE NUMBER 57
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-807-0056
Mailing Address - Fax:787-807-0056
Practice Address - Street 1:CARRETERA 140 KM. 63.5
Practice Address - Street 2:BO. MAGUEYES
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-7784
Practice Address - Fax:787-846-7859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20529Medicaid
PRBF-6968145OtherUSA RX NUMBER
PR20529Medicare ID - Type Unspecified
PRH68142Medicare UPIN