Provider Demographics
NPI:1164639183
Name:DANIELSEN-ZAVALA, AURORA (MD)
Entity Type:Individual
Prefix:DR
First Name:AURORA
Middle Name:
Last Name:DANIELSEN-ZAVALA
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 1:165 AVE HOSTOS
Mailing Address - Street 2:COND. EL MONTE NORTE APT. 239
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4244
Mailing Address - Country:US
Mailing Address - Phone:787-763-5060
Mailing Address - Fax:787-724-6180
Practice Address - Street 1:CALLE ARZUAGA #112 RIO PIEDRAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-767-8758
Practice Address - Fax:844-759-2967
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR05715DM-8208000000X
PR6483208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38079200Medicaid