Healthcare Provider Details

I. General information

NPI: 1699759951
Provider Name (Legal Business Name): YVETTE L. PIOVANETTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE DOMENECH SUITE 413
SAN JUAN PR
00918-3710
US

IV. Provider business mailing address

400 AVE DOMENECH SUITE 413
SAN JUAN PR
00918-3710
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-7383
  • Fax: 787-753-7586
Mailing address:
  • Phone: 787-753-7383
  • Fax: 787-753-7586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6309
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: