Provider Demographics
NPI:1528010725
Name:FELICIANO, NEREIDA I (MD)
Entity Type:Individual
Prefix:DR
First Name:NEREIDA
Middle Name:I
Last Name:FELICIANO
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:PO BOX 9023004
Mailing Address - Street 2:URB. MILAVILLE ST. D, NUMBER 33
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-3004
Mailing Address - Country:US
Mailing Address - Phone:787-579-0820
Mailing Address - Fax:
Practice Address - Street 1:ST. D, URB. MILAVILLE-GARCIA
Practice Address - Street 2:NUMBER 33
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-579-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRBF3752638OtherDEA RERGISTRATION NUMBER
PR008-0169Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER