Provider Demographics
NPI:1417730342
Name:HIMET COLL, FABIANNA
Entity Type:Individual
Prefix:
First Name:FABIANNA
Middle Name:
Last Name:HIMET COLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CLL HIPODROMO 753
Mailing Address - Street 2:APT. 402
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2169
Mailing Address - Country:US
Mailing Address - Phone:787-934-5697
Mailing Address - Fax:
Practice Address - Street 1:LUIS A. FERRE HIGHWAY, EXIT #21
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4968
Practice Address - Country:US
Practice Address - Phone:787-743-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program