Provider Demographics
NPI:1811951353
Name:COLON - FONTANEZ, FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:COLON - FONTANEZ
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:AN36 PLAZA SAN VICENTE
Mailing Address - Street 2:URB. ANTILLANA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6128
Mailing Address - Country:US
Mailing Address - Phone:787-292-6112
Mailing Address - Fax:787-268-5281
Practice Address - Street 1:252 CALLE SAN JORGE
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912-3310
Practice Address - Country:US
Practice Address - Phone:787-268-5281
Practice Address - Fax:787-268-5281
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12154207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG61196Medicare UPIN
PR89079Medicare ID - Type Unspecified