Provider Demographics
NPI:1851509343
Name:FELICIANO-BACENET, RUTH A (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:A
Last Name:FELICIANO-BACENET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:A
Other - Last Name:FELICIANO-BACENET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7157
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7157
Mailing Address - Country:US
Mailing Address - Phone:787-502-3699
Mailing Address - Fax:787-961-4562
Practice Address - Street 1:HIMA SAN PABLO CAGUAS
Practice Address - Street 2:AVE LUIS MUNOZ MARIN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:787-653-3495
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10833207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF52965Medicare UPIN