Healthcare Provider Details

I. General information

NPI: 1053725671
Provider Name (Legal Business Name): MARIA ZELLEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 AVE DOMENECH
SAN JUAN PR
00918-3514
US

IV. Provider business mailing address

QQ27 CALLE 34
BAYAMON PR
00956-4762
US

V. Phone/Fax

Practice location:
  • Phone: 787-466-8641
  • Fax:
Mailing address:
  • Phone: 787-466-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number025170
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: