Provider Demographics
NPI:1104182930
Name:SEDA NAZARIO, LIZMARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LIZMARIE
Middle Name:
Last Name:SEDA NAZARIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO.CAIMITO SECTOR CERRO GORDO
Mailing Address - Street 2:HC 01 BOX 8201
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-208-8974
Mailing Address - Fax:
Practice Address - Street 1:BO.CAIMITO SECTOR CERRO GORDO CARR.128
Practice Address - Street 2:HC 01 BOX 8201
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-208-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRA13649163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse