Provider Demographics
NPI:1942493770
Name:FERNANDEZ, RICARDO (DVM 263)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:DVM 263
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:X12 CALLE 17
Mailing Address - Street 2:ROYAL TOWN
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-4534
Mailing Address - Country:US
Mailing Address - Phone:787-279-7990
Mailing Address - Fax:
Practice Address - Street 1:X12 CALLE 17
Practice Address - Street 2:ROYAL TOWN
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4534
Practice Address - Country:US
Practice Address - Phone:787-279-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPR 263174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian