Provider Demographics
NPI:1255340212
Name:GARRASTEGUI, DELBA I (MD)
Entity type:Individual
Prefix:
First Name:DELBA
Middle Name:I
Last Name:GARRASTEGUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 363327
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3327
Mailing Address - Country:US
Mailing Address - Phone:787-995-1818
Mailing Address - Fax:787-995-1800
Practice Address - Street 1:EXT HERMANAS DAVILA
Practice Address - Street 2:CALLE 8 BLOQUE I32
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5002
Practice Address - Country:US
Practice Address - Phone:787-995-1671
Practice Address - Fax:787-955-1800
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12754207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085539AMedicare PIN
PRH67164Medicare UPIN