MEDICARE: DR. MAGALI MADERA ZAYAS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	15094	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1306961404	OTHER	PR	NPI

General Provider Information

NPI Number	:	1306961404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAGALI MADERA ZAYAS M.D

Provider Business Mailing Address
First Line	:	PO BOX 9548
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00613-9548
Country	:	US
Telephone Number	:	787-814-8049
Fax Number	:	787-814-8048

Provider Business Practice Location Address
First Line	:	CARR 119 KM 6.1 BO PUENTE
Second Line	:	EDIFICIO MENDEZ
City	:	CAMUY
State	:	PR
Zip	:	00627-0000
Country	:	US
Telephone Number	:	787-814-8049
Fax Number	:	787-814-8048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	04/15/2019

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