Healthcare Provider Details

I. General information

NPI: 1740117324
Provider Name (Legal Business Name): MARIA LUISA EARLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANATI MEDICAL PLZ
MANATI PR
00674-5507
US

IV. Provider business mailing address

345 W PALOMINO WAY
STANSBURY PARK UT
84074-1256
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3700
  • Fax:
Mailing address:
  • Phone: 201-403-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberNA
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: