Provider Demographics
NPI:1528299054
Name:FONTANET, RICARDO D (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:D
Last Name:FONTANET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICARDO
Other - Middle Name:D
Other - Last Name:FONTANET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1213 CALLE TOMAS AGRAIT
Mailing Address - Street 2:CLUB MANOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4333
Mailing Address - Country:US
Mailing Address - Phone:787-633-1547
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DISTRICT HOSPITAL
Practice Address - Street 2:MEDICAL CENTER UDH 2 PO 2116
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2116
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12371 I207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery