Provider Demographics
NPI:1891706404
Name:FONTANET, HECTOR O (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:O
Last Name:FONTANET
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:I 25 VIA LLANURAS LA VISTA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4480
Mailing Address - Country:US
Mailing Address - Phone:787-768-8814
Mailing Address - Fax:787-768-8814
Practice Address - Street 1:G07 CAMPO RICO AVE COUNTRY CLUB
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2678
Practice Address - Country:US
Practice Address - Phone:787-769-4079
Practice Address - Fax:787-762-9110
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR91282OtherTRIPLE S