Healthcare Provider Details

I. General information

NPI: 1336904853
Provider Name (Legal Business Name): SANDRA AGUAYO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF MEDICO HNAS DAVILA J16 CALLE 2 SUITE 110
BAYAMON PR
00959-5045
US

IV. Provider business mailing address

EDIF MEDICO HNAS DAVILA J16 CALLE 2 SUITE 110
BAYAMON PR
00959-5045
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-3838
  • Fax: 787-785-6975
Mailing address:
  • Phone: 787-787-3838
  • Fax: 787-785-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SANDRA AGUAYO
Title or Position: DOCTOR
Credential: MD
Phone: 787-907-3838