Provider Demographics
NPI:1780176768
Name:FONTANET SANCHEZ, PABLO ANDRES (MD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:ANDRES
Last Name:FONTANET SANCHEZ
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:GO7 AVE ROBERTO SANCHEZ VILELLA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2678
Mailing Address - Country:US
Mailing Address - Phone:787-633-8153
Mailing Address - Fax:
Practice Address - Street 1:GO7 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2678
Practice Address - Country:US
Practice Address - Phone:787-633-8153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14698208D00000X
PR21993208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice