Provider Demographics
NPI:1720293855
Name:FRONTERA-ENSENAT, FRANCISCO JUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JUAN
Last Name:FRONTERA-ENSENAT
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 2892
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-2892
Mailing Address - Country:US
Mailing Address - Phone:787-833-8391
Mailing Address - Fax:
Practice Address - Street 1:1040 CORAZONES AVE.
Practice Address - Street 2:CORP. FONDO SEGURO DEL ESTADO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681-0000
Practice Address - Country:US
Practice Address - Phone:787-833-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR97132081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF88828Medicare UPIN