Provider Demographics
NPI:1790302693
Name:FELICIANO, DAVID (RT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FELICIANO
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:FELICIANO IRIZARRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RT
Mailing Address - Street 1:JARDINES DE CAPARRA 19TH STREET
Mailing Address - Street 2:N-14
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7810
Mailing Address - Country:US
Mailing Address - Phone:787-447-3759
Mailing Address - Fax:
Practice Address - Street 1:JARDINES DE CAPARRA 19TH STREET
Practice Address - Street 2:N-14
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7810
Practice Address - Country:US
Practice Address - Phone:787-447-3759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1224227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified