Provider Demographics
NPI:1295362283
Name:FRATICELLI RENTERO, LIZBETH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:MARIE
Last Name:FRATICELLI RENTERO
Suffix:
Gender:F
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:URB. CAMINO DEL SUR
Mailing Address - Street 2:SABANERA 399
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-370-8727
Mailing Address - Fax:
Practice Address - Street 1:URB. CAMINO DEL SUR
Practice Address - Street 2:SABANERA 399
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-370-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL167008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine