Provider Demographics
NPI:1720133358
Name:SIMONETTI-FIGUEROA, FERDINAND
Entity Type:Individual
Prefix:
First Name:FERDINAND
Middle Name:
Last Name:SIMONETTI-FIGUEROA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:F.S.
Other - Middle Name:
Other - Last Name:MEDICAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FSMEDICAL
Mailing Address - Street 1:CALLE 28 BLOQUE 9
Mailing Address - Street 2:CASA 9 VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-379-9326
Mailing Address - Fax:787-269-3785
Practice Address - Street 1:PMB 258-2135 CARR. 2
Practice Address - Street 2:SUITE 15
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-379-9326
Practice Address - Fax:787-269-3785
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier