Healthcare Provider Details

I. General information

NPI: 1548014046
Provider Name (Legal Business Name): DRA. YOLANDA CASIANO QUILES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 04/12/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CALLE JOSE A MULET
HORMIGUEROS PR
00660-1823
US

IV. Provider business mailing address

URB HACIENDAS CONSTANCIA 753 CALLE CAFETAL
HORMIGUEROS PR
00660
US

V. Phone/Fax

Practice location:
  • Phone: 787-849-1940
  • Fax:
Mailing address:
  • Phone: 787-849-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. YOLANDA CASIANO QUILES
Title or Position: PRESIDENT
Credential: DDM
Phone: 787-538-2059