Provider Demographics
NPI:1285661769
Name:FEBO, IRMA L (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:L
Last Name:FEBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PANORAMA
Mailing Address - Street 2:CALLE #1 13-14
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-4411
Mailing Address - Country:US
Mailing Address - Phone:787-279-8525
Mailing Address - Fax:787-777-3227
Practice Address - Street 1:UNIVERSITY PEDIATRIC HOSPITAL
Practice Address - Street 2:OFFICE 1 A 29
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-756-4020
Practice Address - Fax:787-777-3227
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9523174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist