Provider Demographics
NPI:1760742951
Name:NAZARIO, YAMIL (MS,H,)
Entity Type:Individual
Prefix:
First Name:YAMIL
Middle Name:
Last Name:NAZARIO
Suffix:
Gender:M
Credentials:MS,H,
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 21751
Mailing Address - Street 2:RIO PIEDRAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00931-1751
Mailing Address - Country:US
Mailing Address - Phone:787-553-6301
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA RAFAEL CORDERO, ESQUINA TROCHE
Practice Address - Street 2:PLAZA SALUD S.A.N.O.S.
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-553-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2640101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)