Provider Demographics
NPI:1598732190
Name:ZAYAS-TORO, ILIA E
Entity Type:Individual
Prefix:DR
First Name:ILIA
Middle Name:E
Last Name:ZAYAS-TORO
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:B7 CALLE SANTA CRUZ
Mailing Address - Street 2:AVE SANTA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6902
Mailing Address - Country:US
Mailing Address - Phone:787-780-9196
Mailing Address - Fax:787-778-4793
Practice Address - Street 1:B7 CALLE SANTA CRUZ
Practice Address - Street 2:AVE SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6902
Practice Address - Country:US
Practice Address - Phone:787-780-9196
Practice Address - Fax:787-778-4793
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD26755Medicare UPIN
PR0099318Medicare ID - Type UnspecifiedPROVIDER NUMBER