Provider Demographics
NPI:1760692404
Name:APONTE, NYDIA M (OTL)
Entity Type:Individual
Prefix:MRS
First Name:NYDIA
Middle Name:M
Last Name:APONTE
Suffix:
Gender:F
Credentials:OTL
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Mailing Address - Street 1:408 BLVD MEDIA LUNA APT 4803
Mailing Address - Street 2:VEREDAS DEL PARQUE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-4972
Mailing Address - Country:US
Mailing Address - Phone:787-776-2454
Mailing Address - Fax:787-776-2454
Practice Address - Street 1:1106 TENIENTE CESAR GONZALEZ STREET
Practice Address - Street 2:VILLA NEVAREZ
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00928
Practice Address - Country:US
Practice Address - Phone:787-758-8019
Practice Address - Fax:787-764-3657
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR552174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist