Provider Demographics
NPI:1265541825
Name:ZAYAS, ELOISA SR (BA)
Entity type:Individual
Prefix:MRS
First Name:ELOISA
Middle Name:
Last Name:ZAYAS
Suffix:SR
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:ELOISA
Other - Middle Name:
Other - Last Name:ZAYAS
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:BA
Mailing Address - Street 1:HC 72 BOX 4047
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-9721
Mailing Address - Country:US
Mailing Address - Phone:787-869-7927
Mailing Address - Fax:787-869-5873
Practice Address - Street 1:CARR 152 KM 125 BO CEDRO ARRIBA
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-9721
Practice Address - Country:US
Practice Address - Phone:787-869-7927
Practice Address - Fax:787-869-5873
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
55593Medicare ID - Type Unspecified