Provider Demographics
NPI:1184738023
Name:ABREU, EVELYN (DDS)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:ABREU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 AVE BARBOSA
Mailing Address - Street 2:SUITE 206 ARECIBO MEDICAL PLAZA
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-2799
Mailing Address - Country:US
Mailing Address - Phone:787-817-8030
Mailing Address - Fax:787-880-4542
Practice Address - Street 1:65 AVE BARBOSA
Practice Address - Street 2:SUITE 206 ARECIBO MEDICAL PLAZA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2799
Practice Address - Country:US
Practice Address - Phone:787-817-8030
Practice Address - Fax:787-880-4542
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22131223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2213OtherLICENSE