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Individual

HECTOR MORENO FUENTES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
431 TULANE, VEGA BAJA, PR 00693
(787) 382-4410
Mailing address
431 TULANE, VEGA BAJA, PR 00693

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19497
PR
208D00000X
General Practice Physician
19497
PR
390200000X
Student in an Organized Health Care Education/Training Program
13989I
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356713176
PR
Enumeration date
10/21/2015
Last updated
09/02/2021
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