Provider Demographics
NPI:1316186182
Name:FRATTALLONE, JOSEPHINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:MARIE
Last Name:FRATTALLONE
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 1:299 CAMINO DEL SOL
Mailing Address - Street 2:URB. SABANERA
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-9447
Mailing Address - Country:US
Mailing Address - Phone:787-640-0449
Mailing Address - Fax:787-793-7003
Practice Address - Street 1:299 CAMINO DEL SOL
Practice Address - Street 2:URB. SABANERA
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-9447
Practice Address - Country:US
Practice Address - Phone:787-640-0449
Practice Address - Fax:787-793-7003
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR81232080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine