Provider Demographics
NPI:1487699906
Name:DUBOCQ-BERDEGUEZ, FRANCISCO MANUEL (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:MANUEL
Last Name:DUBOCQ-BERDEGUEZ
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:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1847
Mailing Address - Country:US
Mailing Address - Phone:787-786-5305
Mailing Address - Fax:787-740-2140
Practice Address - Street 1:TORRE SAN PABLO, SUITE 101
Practice Address - Street 2:68 CALLE SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7031
Practice Address - Country:US
Practice Address - Phone:787-786-5305
Practice Address - Fax:787-740-2140
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229822208800000X
PR9736208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038614701Medicaid
PR038614701Medicaid