Provider Demographics
NPI:1447457700
Name:SALLENT AQUINO, FREDDY (MD)
Entity type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:
Last Name:SALLENT AQUINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FREDDY
Other - Middle Name:
Other - Last Name:SALLENT AQUINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:CARRETERA 787 KM 15
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1400
Mailing Address - Country:US
Mailing Address - Phone:787-739-5555
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 787 KM 1.5
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-1400
Practice Address - Country:US
Practice Address - Phone:787-739-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine