Provider Demographics
NPI:1932294477
Name:PAZ FIGUEROA, ANABELLE
Entity Type:Individual
Prefix:
First Name:ANABELLE
Middle Name:
Last Name:PAZ FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6429 CARR. #2 PMB 48
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:787-612-8109
Mailing Address - Fax:787-895-6315
Practice Address - Street 1:CARR. 2 KM. 96.8 BO. COCOS
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-612-8109
Practice Address - Fax:787-895-6315
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15764208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15764OtherSTATE LICENCE
PR0023243Medicare ID - Type Unspecified
PRI-39358Medicare UPIN