Provider Demographics
NPI:1265540678
Name:FEBO, HORIDEL GUADALUPE (MD)
Entity type:Individual
Prefix:DR
First Name:HORIDEL
Middle Name:GUADALUPE
Last Name:FEBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:40 CALLE TANAGRA
Mailing Address - Street 2:URB. APOLO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5009
Mailing Address - Country:US
Mailing Address - Phone:787-763-6201
Mailing Address - Fax:787-763-4248
Practice Address - Street 1:207 AVE DOMENECH
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3523
Practice Address - Country:US
Practice Address - Phone:787-763-6201
Practice Address - Fax:787-763-4248
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9265207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83125Medicare ID - Type Unspecified
PRG41396Medicare UPIN