Provider Demographics
NPI:1023085065
Name:FICA, JUAN (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:
Last Name:FICA
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 1:1389 W MAIN ST
Mailing Address - Street 2:TOWER 2, SUITE 320
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3104
Mailing Address - Country:US
Mailing Address - Phone:203-753-9313
Mailing Address - Fax:203-573-8976
Practice Address - Street 1:1389 W MAIN ST
Practice Address - Street 2:TOWER 2, SUITE 320
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3104
Practice Address - Country:US
Practice Address - Phone:203-753-9313
Practice Address - Fax:203-573-8976
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT020699207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2551043OtherAETNA
CT719283OtherCONNECTICARE
CT00120699401OtherBLUE CARE FAMILY PLAN
CT010020699CT01OtherANTHEM BC/BS
CT0V9580OtherHEALTHNET
CT20699OtherCT HEALTH PLAN
CT29427OtherGROUP HEALTH INC.
CT0469525004OtherCIGNA
CT129427OtherWELLCARE/MEDICARE
CTC64866Medicare UPIN