Healthcare Provider Details

I. General information

NPI: 1386439214
Provider Name (Legal Business Name): RICARDO CHARRIEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PAVIA ESQ, 700 CALLE DR. MANUEL F, AV. MANUEL FERNANDEZ
SAN JUAN PR
00909
US

IV. Provider business mailing address

PO BOX 8838
SAN JUAN PR
00910-0838
US

V. Phone/Fax

Practice location:
  • Phone: 787-296-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: