Healthcare Provider Details

I. General information

NPI: 1235828336
Provider Name (Legal Business Name): DANELLY OLIVO FIGUEROA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

V7 CALLE SAN MARCOS
FAJARDO PR
00738-5044
US

IV. Provider business mailing address

V7 CALLE SAN MARCOS
FAJARDO PR
00738-5044
US

V. Phone/Fax

Practice location:
  • Phone: 787-392-9770
  • Fax: 787-763-2480
Mailing address:
  • Phone: 787-392-9770
  • Fax: 787-763-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16219
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: