IndividualActive
Edgar Domenech Fagundo, MD
NPI 1386717247 · Plastic Surgery within the Head & Neck (Otolaryngology) Physician · Ponce, PR
Provider details
- NPI number
- 1386717247
- Entity type
- Individual
- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 13247 (PR)
Specialties & taxonomies
- Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianPrimary207YX0007XLicense 13247 (PR)
Allopathic & Osteopathic Physicians
Practice location
Torre Medica San Lucas, Ave. Tito Castro 917
Suite 618
Ponce, PR 00730
Phone: (787) 290-3333
Fax: (787) 290-4444
Mailing address
Pmb 137 Po Box 2000
Mercedita, PR 00715
Registry dates
- Enumerated
- 2006-11-16
- Last updated
- 2010-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.