Provider Demographics
NPI:1790993384
Name:MONCLOVA, ZAIDA (BSN)
Entity Type:Individual
Prefix:MS
First Name:ZAIDA
Middle Name:
Last Name:MONCLOVA
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CALLE EMAJAGUILLA
Mailing Address - Street 2:URB. LOS FLAMBOYANES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-2765
Mailing Address - Country:US
Mailing Address - Phone:787-903-1619
Mailing Address - Fax:
Practice Address - Street 1:900 CALLE CERRA
Practice Address - Street 2:CDT GUALBERTO RABELL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5104
Practice Address - Country:US
Practice Address - Phone:787-721-3220
Practice Address - Fax:787-721-3207
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20980163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent