Individual
GIANNINA COPPOLA-FASICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
A28 CALLE C, CAROLINA, PR 00987-7102
(787) 257-2040
Mailing address
1789 CARR 21 STE 302, SAN JUAN, PR 00921-3337
(787) 764-2030
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
19570
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038915800
—
PR
Enumeration date
03/24/2014
Last updated
01/31/2023
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