Provider Demographics
NPI:1508851262
Name:ZAVALA, HECTOR G (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:G
Last Name:ZAVALA
Suffix:
Gender:M
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:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0213
Mailing Address - Country:US
Mailing Address - Phone:787-704-0433
Mailing Address - Fax:787-704-0435
Practice Address - Street 1:Y31 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6478
Practice Address - Country:US
Practice Address - Phone:787-704-0433
Practice Address - Fax:787-704-0435
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12539207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH82241Medicare UPIN
PR0080303Medicare ID - Type Unspecified