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General NPI Number Information
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NPI Number | 1609074756
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Entity Type | Individual
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Provider Name | RICARDO JOSE FABRE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | ARTURO CADILLA 405 PASEO SAN PABLO #100
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-740-2507
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Fax |
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Provider Business Mailing Address
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Address Line | SAN PATRICIO I APT. 10-A E-13 CALLE1
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-740-2507
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 7799
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License Number State | PR
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