Doctor Name: | DR. JOSE LUIS FOSSAS BLANCO |
NPI Number: | 1144209859 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 9255 |
Business Practice Address: | Bayamon Medical Plaza Ste 108 Bayamon, PR - 00959 |
Business Phone Number: | 7877402040 |
Business Fax Number: | 7872888183 |
Mailing Address: | Bayamon Medical Plaza, Ste 108 BAYAMON |
State: | PR |
Postal Code: | 00959 |
Phone Number: | 7877402040 |
Fax Number: | 7872888183 |
NPI Enumeration Date: | 01/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 9255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |