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General NPI Number Information
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NPI Number | 1215259627
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Entity Type | Individual
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Provider Name | FEDERICO ALBERTO CORICA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 2435 BLVD LUIS A FERRE
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City | PONCE
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State | PR
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Zip | 00717-2112
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Country | US
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Telephone | 787-866-3355
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2908
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City | GUAYAMA
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State | PR
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Zip | 00785-2908
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Country | US
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Telephone | 787-866-2732
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Fax | 787-866-2732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 17818
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License Number State | PR
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