Provider Demographics
NPI:1508972985
Name:MONSERRATE, DENNISE T (MD)
Entity Type:Individual
Prefix:MRS
First Name:DENNISE
Middle Name:T
Last Name:MONSERRATE
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:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-889-6012
Mailing Address - Fax:787-889-3191
Practice Address - Street 1:28 CALLE FERNANDEZ GARCIA
Practice Address - Street 2:LOCAL #20
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-1449
Practice Address - Country:US
Practice Address - Phone:787-889-6012
Practice Address - Fax:787-889-3191
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11346208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
83797Medicare ID - Type Unspecified
G41512Medicare UPIN