Provider Demographics
NPI:1477948677
Name:FELIBERTI, JOSE ROSA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ROSA
Last Name:FELIBERTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4327 AVE ISLA VERDE APT 802
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5223
Mailing Address - Country:US
Mailing Address - Phone:904-318-7897
Mailing Address - Fax:
Practice Address - Street 1:CARR 164 SECTOR EL DESVIO
Practice Address - Street 2:BO ACHIOTE
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0515
Practice Address - Country:US
Practice Address - Phone:787-869-1290
Practice Address - Fax:787-869-1800
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1506572084P0800X
CA390200000X
PR226792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program