Provider Demographics
NPI:1801669213
Name:VISALDEN, SUJAILY (MD)
Entity type:Individual
Prefix:
First Name:SUJAILY
Middle Name:
Last Name:VISALDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:RR 5 BOX 9015
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9242
Mailing Address - Country:US
Mailing Address - Phone:787-974-3052
Mailing Address - Fax:
Practice Address - Street 1:URB. DIAZ CALLE 2 B6 GALATEO
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00954-0095
Practice Address - Country:US
Practice Address - Phone:787-974-3052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical