Provider Demographics
NPI:1205812492
Name:DEVARIE, NORMA A (MD)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:A
Last Name:DEVARIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1002 CALLE 44 SE
Mailing Address - Street 2:REPARTO METROLITANO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2719
Mailing Address - Country:US
Mailing Address - Phone:787-765-8977
Mailing Address - Fax:787-282-6059
Practice Address - Street 1:138 AVE WINSTON CHURCHILL
Practice Address - Street 2:BOX 844
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6013
Practice Address - Country:US
Practice Address - Phone:787-765-8977
Practice Address - Fax:787-282-6059
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist