Provider Demographics
NPI:1043289226
Name:CORREA JUSINO, FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:CORREA JUSINO
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:PO BOX 1457
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1457
Mailing Address - Country:US
Mailing Address - Phone:787-876-4555
Mailing Address - Fax:787-876-4555
Practice Address - Street 1:CALLE 1
Practice Address - Street 2:B-1 VILLAS DE LUIZA
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-4555
Practice Address - Fax:787-876-4555
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5965208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C77368Medicare UPIN
PR25807Medicare ID - Type Unspecified