MEDICARE: DR. SYLVIA MONSERRATE NUNEZ FIDALGO

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	14729	PR

General Provider Information

NPI Number	:	1366487597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIA MONSERRATE NUNEZ FIDALGO

Provider Business Mailing Address
First Line	:	URB. VALPARAISO CALLE 3 J-6
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00940-4040
Country	:	US
Telephone Number	:	787-315-2879
Fax Number	:	787-261-6530

Provider Business Practice Location Address
First Line	:	900 CALLE CERRA
Second Line	:	ESQ CALLE HOARE PDA 15
City	:	SAN JUAN
State	:	PR
Zip	:	00907-5104
Country	:	US
Telephone Number	:	787-977-0520
Fax Number	:

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

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	03/04/2008

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