NPIMap

Organization Active NPI

Fajardo Medical Practice

  • General Practice Physician
  • Fajardo, PR
National Provider Identifier
1134319320
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FAJARDO MEDICAL PRACTICE
Practice address
I23 Calle Principal
Urb Baralt
Fajardo, PR 00738-3772
Phone
(787) 863-7646
Fax
(787) 860-7357
NPI assigned
Jul 25, 2007
Organization subpart
Yes
Parent organization
FAJARDO MEDICAL PRACTICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Agapito Fontanez Nieves, M.D.
Title
Presidente
Phone
(787) 863-7646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

I23 Calle Principal
Urb Baralt
Fajardo, PR 00738-3772

Mailing address

PO Box 827
Fajardo, PR 00738-0827
Phone (787) 863-7646

National Provider Directory

National Provider Directory
Tax ID family
Fajardo Medical Practice2 organizations share this tax ID, including this one
Part of
Fajardo Medical Practice

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1134319320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007380827",
            "telephone_number": "787-863-7646",
            "fax_number": "787-860-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "I23 CALLE PRINCIPAL",
            "address_2": "URB BARALT",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383772",
            "telephone_number": "787-863-7646",
            "fax_number": "787-860-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAJARDO MEDICAL PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAJARDO MEDICAL PRACTICE",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "FONTANEZ NIEVES",
        "authorized_official_first_name": "AGAPITO",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-863-7646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.