Provider Demographics
NPI:1396235958
Name:FONT GARCIA, MARIO ANDRES (MD)
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:ANDRES
Last Name:FONT GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61C CALLE 2
Mailing Address - Street 2:PASEO LAS VISTAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-509-3009
Mailing Address - Fax:
Practice Address - Street 1:61C CALLE2
Practice Address - Street 2:PASEO LAS VISTAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-509-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-06-14
Deactivation Date:2018-05-23
Deactivation Code:
Reactivation Date:2018-06-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program