Jose Arnaldo Fontanillas Pino – Pediatrics Physician

Key facts

NPI: 1871501239
Entity type: Individual (NPI type 1)
Primary specialty: Pediatrics Physician 208000000X
License: 8663 (PR)
Practice address: Carr #2 KM 96.7 Bo Cocos
2ND Piso Farmacia Gloriana
Quebradillas, PR 00678
Phone: (787) 895-4052
Fax: (787) 895-1188
NPI assigned: Aug 3, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Dr Ja Fontanillas CSP Pediatrics Physician · Quebradillas, PR · NPI 1376596171

NPD (past) PEDIATRICS

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
8663	PR	MD	Pediatrics Physician

Practice roles

Organization	Specialty	Status	New patients
Dr Ja Fontanillas CSP	Pediatrics	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatrics Physician	208000000X	8663	PR	Yes

Addresses

Primary practice location

Carr #2 KM 96.7 Bo Cocos
2ND Piso Farmacia Gloriana
Quebradillas, PR 00678

Mailing address

PO Box 1456
Quebradillas, PR 00678-1456
Phone (787) 895-4052

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 22, 2012.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1871501239",
    "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": "CARR #2 KM 96.7 BO COCOS",
            "address_2": "2ND PISO FARMACIA GLORIANA",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-895-4052",
            "fax_number": "787-895-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANILLAS PINO",
        "first_name": "JOSE",
        "middle_name": "ARNALDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "8663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quebradillas, PR

All providers in Quebradillas, PR · Pediatrics Physician in Puerto Rico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.