Basic Information
Provider Information
NPI: 1790762334
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMADOR
FirstName: FRANCISCO
MiddleName: JOSE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 902 AVE PONCE DE LEON
Address2: MIRAMAR EMBASSY APT.1006
City: SAN JUAN
State: PR
PostalCode: 009073367
CountryCode: US
TelephoneNumber: 7874131111
FaxNumber:  
Practice Location
Address1: 435 AVE HOSTOS
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009183014
CountryCode: US
TelephoneNumber: 7877539515
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/26/2005
LastUpdateDate: 02/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X12959PRY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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