Doctor Name: | DR. JAVIER PUENTES |
NPI Number: | 1679946982 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 019206 |
Business Practice Address: | 3919 Ave Isla Verde Cond Reef Tower Apt 7-e Carolina, PR - 009796717 |
Business Phone Number: | 7862613762 |
Business Fax Number: | |
Mailing Address: | 3919 Ave Isla Verde, Cond Reef Tower Apartment 7-e CAROLINA |
State: | PR |
Postal Code: | 00979 |
Phone Number: | 7862613762 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2015 |
NPI Last Update Date: | 11/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 019206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |