Provider Demographics
NPI:1790540912
Name:AGUAYO MERLY, ANGEL MANUEL
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:MANUEL
Last Name:AGUAYO MERLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CALLE NEPTUNO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-6395
Mailing Address - Country:US
Mailing Address - Phone:787-586-6022
Mailing Address - Fax:
Practice Address - Street 1:54 CALLE NEPTUNO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6395
Practice Address - Country:US
Practice Address - Phone:787-586-6022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program