Provider Demographics
NPI:1457669194
Name:BORRERO, GLORIA IRIS
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:IRIS
Last Name:BORRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 04 7309
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00795
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HC 04 7309
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00795
Practice Address - Country:UM
Practice Address - Phone:939-248-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6715163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse