Individual provider Active NPI

Carlos R. Fuentes-Borrero, M.D.

  • Primary Care Clinic/Center
  • Aibonito, PR
National Provider Identifier
1417059809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
7024 Issued in PR
Practice address
53 N. Baldorioty St
Aibonito, PR 00705-2013
Phone
(787) 735-6330
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 7024 PR Primary

Addresses

Primary practice location

53 N. Baldorioty St
Aibonito, PR 00705-2013

Mailing address

53 N. Baldorioty St
Box 2013
Aibonito, PR 00705-2013
Phone (787) 735-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216001090 PR Practitioner - Family Practice 9436347432 Practice locations: Aibonito, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

53 N Baldorioty St
Aibonito, PR 00705-2013
Phone (787) 735-6330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7024PRMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417059809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 N. BALDORIOTY ST",
            "address_2": "BOX 2013",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007052013",
            "telephone_number": "787-735-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 N. BALDORIOTY ST",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007052013",
            "telephone_number": "787-735-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES-BORRERO",
        "first_name": "CARLOS",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "7024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.