Healthcare Provider Details

I. General information

NPI: 1073517355
Provider Name (Legal Business Name): MYRIAM ZAHYDEE ALLENDE-VIGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MYRIAM ZAYDEE ALLENDE-VIGO MD MBA

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 J. FRANCESCHI ST. URB. PEREYO
HUMACAO PR
00791-3948
US

IV. Provider business mailing address

PO BOX 364246
SAN JUAN PR
00936-4246
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-5313
  • Fax: 787-765-9183
Mailing address:
  • Phone: 787-852-5313
  • Fax: 787-765-9183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4962
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: