Provider Demographics
NPI:1568589265
Name:ESTABIL, MARITZA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:L
Last Name:ESTABIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:URBANIZACION STELLA
Mailing Address - Street 2:A65 CALLE LIRIO
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-1909
Mailing Address - Country:US
Mailing Address - Phone:787-835-1665
Mailing Address - Fax:787-836-5465
Practice Address - Street 1:PENUELAS MEDICAL BUILDING
Practice Address - Street 2:CARRETERA 385 KM 05 OFFICE 105
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-836-5465
Practice Address - Fax:787-836-5465
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14015208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH68435Medicare UPIN
PR0020725Medicare ID - Type UnspecifiedPROVIDER NUMBER