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General NPI Number Information
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NPI Number | 1457759797
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Entity Type | Organization
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Legal Business Name | CARIBBEAN ORTHOPEDIC INSTITUTE PSC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 1213 CALLE TOMAS AGRAIT CLUB MANOR
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City | SAN JUAN
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State | PR
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Zip | 00924-4333
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Country | US
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Telephone | 787-633-1547
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 T. AGRAIT, CLUB MANOR
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-633-1547
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICARDO DAVID FONTANET
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Credential | M.D.
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Telephone | 787-633-1547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 18492
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License Number State | PR
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