Dr Ja Fontanillas CSP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8663 Issued in PR

Legal business name

DR JA FONTANILLAS CSP

Practice address

Car #2 KM 96.7
Bo Cocos, 2ND Floor Farmacia Gloriana
Quebradillas, PR 00678

Phone

(787) 895-4052

Fax

(787) 895-1188

NPI assigned

May 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose Arnoldo Fontanillas, MD

Title

Pediatrician

Phone

(787) 895-4052

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Arnaldo Fontanillas Pino, MD

  • Pediatrics Physician
  • Quebradillas, PR
  • NPI 1871501239
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376596171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1456",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781456",
            "telephone_number": "787-895-4052",
            "fax_number": "787-895-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAR #2 KM 96.7",
            "address_2": "BO COCOS, 2ND FLOOR FARMACIA GLORIANA",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-895-4052",
            "fax_number": "787-895-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JA FONTANILLAS CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONTANILLAS",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ARNOLDO",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "787-895-4052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Quebradillas, PR
• Providers in Quebradillas, PR by specialty
• Pediatrics Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.