Healthcare Provider Details

I. General information

NPI: 1851921936
Provider Name (Legal Business Name): FABIO ALEJANDRO SQUICIMARI DE CARDENAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CALLE GAUTIER BENITEZ STE 201
CAGUAS PR
00725-5527
US

IV. Provider business mailing address

201 CALLE GAUTIER BENITEZ STE 201
CAGUAS PR
00725-5527
US

V. Phone/Fax

Practice location:
  • Phone: 787-746-7441
  • Fax: 787-746-3190
Mailing address:
  • Phone: 787-746-7441
  • Fax: 787-746-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number023702
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: