Provider Demographics
NPI:1336319011
Name:APELLANIZ, ILIA MARIA (EDD)
Entity Type:Individual
Prefix:DR
First Name:ILIA
Middle Name:MARIA
Last Name:APELLANIZ
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 AVE HOSTOS
Mailing Address - Street 2:URBANIZACION BALDRICH
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4038
Mailing Address - Country:US
Mailing Address - Phone:787-765-3411
Mailing Address - Fax:
Practice Address - Street 1:585 AVE HOSTOS
Practice Address - Street 2:URBANIZACION BALDRICH
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4038
Practice Address - Country:US
Practice Address - Phone:787-765-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily