Provider Demographics
NPI:1972579571
Name:VIZCARRONDO, FRANCISCO J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:J
Last Name:VIZCARRONDO
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 366293
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6293
Mailing Address - Country:US
Mailing Address - Phone:787-860-0618
Mailing Address - Fax:787-863-4128
Practice Address - Street 1:305 AVE GENERAL VALERO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4844
Practice Address - Country:US
Practice Address - Phone:787-860-0618
Practice Address - Fax:787-863-4128
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005827207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005827OtherPR LICENSE
PRD26683Medicare UPIN
PR005827OtherPR LICENSE