Provider Demographics
NPI:1679560460
Name:SANABRIA-HILERIO, NELSON IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:IVAN
Last Name:SANABRIA-HILERIO
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:HC 1 BOX 16776
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9348
Mailing Address - Country:US
Mailing Address - Phone:787-891-4803
Mailing Address - Fax:
Practice Address - Street 1:CARR 107
Practice Address - Street 2:SUITE E
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5970
Practice Address - Country:US
Practice Address - Phone:787-882-6301
Practice Address - Fax:787-882-6301
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16039208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice