Provider Demographics
NPI:1053368985
Name:FUENTES-APONTE, ANSELMO (MD)
Entity type:Individual
Prefix:DR
First Name:ANSELMO
Middle Name:
Last Name:FUENTES-APONTE
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 1:2765 AVE DOS PALMAS STE 102
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4136
Mailing Address - Country:US
Mailing Address - Phone:787-784-5000
Mailing Address - Fax:866-296-9467
Practice Address - Street 1:2765 AVE DOS PALMAS STE 102
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4136
Practice Address - Country:US
Practice Address - Phone:787-784-5000
Practice Address - Fax:866-296-9467
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261171100000X
PR9033207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
500419EOtherMMM
81262OtherTRIPLE S
9500015OtherHUMANA INSURANCE
29033OtherCIGNA
9033OtherLICENCIA MEDICO
067358OtherCA
PR3567OtherPREFERRED MEDICARE CHOICE (PMC)
HB25P09033 HIFPOtherHUMANA HEALTH PLUS
PE2379OtherPALIC
HB25P09033 HIFPOtherHUMANA HEALTH PLUS
PR$$$$$$$$$OtherCOSVIMEDCARE
PR3567OtherPREFERRED MEDICARE CHOICE (PMC)