Provider Demographics
NPI:1407867013
Name:ABELLA, RICARDO
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:ABELLA
Suffix:
Gender:M
Credentials:
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 363094
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:T18 AVE RUIZ SOLER
Practice Address - Street 2:JARDINES DE CAPARRA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7708
Practice Address - Country:US
Practice Address - Phone:787-787-2621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice