Provider Demographics
NPI:1508191487
Name:ANZALOTA DEL TORO, LIZA VERONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZA
Middle Name:VERONICA
Last Name:ANZALOTA DEL TORO
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 1:2000 CARR 8177
Mailing Address - Street 2:SUITE 26 BMB 229
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 CARR 8177
Practice Address - Street 2:SUITE 26 BMB 229
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-3733
Practice Address - Country:US
Practice Address - Phone:787-464-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17773208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice