Provider Demographics
NPI:1740277938
Name:BERMUDEZ, FRANCISCO L (DMD, PHD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:L
Last Name:BERMUDEZ
Suffix:
Gender:M
Credentials:DMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 209
Mailing Address - Street 2:P.O. BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-641-4646
Mailing Address - Fax:787-641-4644
Practice Address - Street 1:SUITE 305 CAROLINA SHOPPING COURT
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-641-4646
Practice Address - Fax:787-641-4644
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40161OtherTRIPLE S
PR061422OtherLA CRUZ AZUL