Provider Demographics
NPI:1013005875
Name:ROSARIO FELICIANO, RALPHIE ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPHIE
Middle Name:ALBERTO
Last Name:ROSARIO FELICIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-793-5223
Mailing Address - Fax:325-793-5236
Practice Address - Street 1:1665 ANTILLEY RD STE 260
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-793-5223
Practice Address - Fax:325-793-5236
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME97016OtherSTATE LICENSE
FR0009666OtherDEA LICENSE