Provider Demographics
NPI:1609074756
Name:FABRE, RICARDO JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:JOSE
Last Name:FABRE
Suffix:
Gender:M
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:SAN PATRICIO I APT. 10-A
Mailing Address - Street 2:E-13 CALLE1
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-740-2507
Mailing Address - Fax:
Practice Address - Street 1:ARTURO CADILLA 405
Practice Address - Street 2:PASEO SAN PABLO #100
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-740-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR77992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry