Provider Demographics
NPI:1982688776
Name:PENA FIGUEROA, LUIS (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:PENA FIGUEROA
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 563
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0563
Mailing Address - Country:US
Mailing Address - Phone:787-796-7897
Mailing Address - Fax:787-796-5163
Practice Address - Street 1:155 AVE DR PEDRO ALBIZU CAMPOS
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-2419
Practice Address - Country:US
Practice Address - Phone:787-796-7897
Practice Address - Fax:787-796-5163
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10005208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082108Medicare ID - Type Unspecified
PRE57387Medicare UPIN