Provider Demographics
NPI:1659469468
Name:CASANOVA, MARIA DEL PILAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA DEL PILAR
Middle Name:
Last Name:CASANOVA
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 4038
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4038
Mailing Address - Country:US
Mailing Address - Phone:787-858-4702
Mailing Address - Fax:
Practice Address - Street 1:# 2 STREET, KM. 50, CDT MUNICIPAL DE MANATI
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-0976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6370261QP2300X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84490OtherGRUPAL (MEDICARE & REFORM
PR29320Medicare ID - Type UnspecifiedREASSIGNING
PRC82127Medicare UPIN