Provider Demographics
NPI:1568993376
Name:RECIO, FERNANDO O III
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:O
Last Name:RECIO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 N FEDERAL HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3230
Mailing Address - Country:US
Mailing Address - Phone:561-997-8991
Mailing Address - Fax:
Practice Address - Street 1:6200 N FEDERAL HWY STE 101
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3230
Practice Address - Country:US
Practice Address - Phone:561-997-8991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0143131207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology