Provider Demographics
NPI:1144383852
Name:TALAVERA, DENYSSE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DENYSSE
Middle Name:E
Last Name:TALAVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. PLAZA INMACULADA TORRE II
Mailing Address - Street 2:APT. 1908
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-727-2417
Mailing Address - Fax:
Practice Address - Street 1:POLICLINICA DR. TALAVERA
Practice Address - Street 2:CALLE MUNOZ RIVERA #27 ALTOS
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-382-2417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11660208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice