Basic Information
| Provider Information | |||||||||
| NPI: | 1528299054 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FONTANET | ||||||||
| FirstName: | RICARDO | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | FONTANET | ||||||||
| OtherFirstName: | RICARDO | ||||||||
| OtherMiddleName: | D | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1213 CALLE TOMAS AGRAIT | ||||||||
| Address2: | CLUB MANOR | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009244333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876331547 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY DISTRICT HOSPITAL | ||||||||
| Address2: | MEDICAL CENTER UDH 2 PO 2116 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009222116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2009 | ||||||||
| LastUpdateDate: | 06/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 12371 I | PR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.