Individual
MR. EDMAN FUENTES
Active
Individual
MR. EDMAN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA.008727
CO
363AS0400X
Surgical Physician Assistant
Primary
PA51630
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291613400
—
FL
01
—
PA51630
MEDICAL LICENSE
CA
01
—
PA9102297
MEDICAL LICENSE
FL
Enumeration date
01/30/2006
Last updated
01/21/2025
Update your record
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