Basic Information
| Provider Information | |||||||||
| NPI: | 1740632371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRATICELLI ROSADO | ||||||||
| FirstName: | RICARDO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9163 CALLE MARINA | ||||||||
| Address2: | APT 509B | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007172006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9396403747 | ||||||||
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| Practice Location | |||||||||
| Address1: | 917 AVE TITO CASTRO | ||||||||
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| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007164717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878404545 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2016 | ||||||||
| LastUpdateDate: | 12/16/2017 | ||||||||
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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 | 282N00000X | 32751 | PR | N | Hospitals | General Acute Care Hospital | 208600000X | 33246 | PR | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.