Basic Information
Provider Information
NPI: 1053779173
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIGUEROA
FirstName: JANMARY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 58 CALLE JARDINES DEL CARIBE
Address2: 4327
City: PONCE
State: PR
PostalCode: 007281115
CountryCode: US
TelephoneNumber: 7875326123
FaxNumber:  
Practice Location
Address1: 206 N FLORIDA AVE
Address2:  
City: LAKELAND
State: FL
PostalCode: 338014902
CountryCode: US
TelephoneNumber: 8632097003
FaxNumber: 8632843083
Other Information
ProviderEnumerationDate: 02/03/2016
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000X31919PRN Allopathic & Osteopathic PhysiciansGeneral Practice 
207R00000XME132368FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home