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Individual

DR. RICARDO M. FONTANET GRANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
GO7 AVE CAMPO RICO, COUNTRY CLUB, CAROLINA, PR 00982-2678
(787) 633-8152
(787) 762-9110
Mailing address
GO7 AVE CAMPO RICO, COUNTRY CLUB, CAROLINA, PR 00982-2678
(787) 633-8152
(787) 762-9110

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9201
PR
208D00000X
General Practice Physician
9201
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061680
CRUZ AZUL
PR
01
129660590181
GLOBAL
PR
01
81706
SSS INSURANCE
PR
01
9820006
HUMANA
PR
01
P-1319
PALIC
PR
Enumeration date
08/18/2005
Last updated
11/10/2020
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