Provider Demographics
NPI:1881654275
Name:NATER, KYRA Z (MD)
Entity Type:Individual
Prefix:DR
First Name:KYRA
Middle Name:Z
Last Name:NATER
Suffix:
Gender:F
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:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-733-3130
Mailing Address - Fax:787-733-3130
Practice Address - Street 1:CALLE JOSE CELSO BARBOSA 219
Practice Address - Street 2:EDIFICIO FARMACIA SUNLLO
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-3130
Practice Address - Fax:787-733-3130
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13496208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H55193Medicare UPIN
0020852Medicare ID - Type Unspecified