Provider Demographics
NPI:1043213556
Name:FELICIANO VALERA, RICARDO (MD)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:
Last Name:FELICIANO VALERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361738
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1738
Mailing Address - Country:US
Mailing Address - Phone:787-728-6902
Mailing Address - Fax:787-728-6902
Practice Address - Street 1:258 CALLE SAN JORGE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3239
Practice Address - Country:US
Practice Address - Phone:787-728-6902
Practice Address - Fax:787-728-6902
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7426207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology