Healthcare Provider Details

I. General information

NPI: 1679655518
Provider Name (Legal Business Name): EVELYN ZAMBRANA GRACIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CASIA STREET VA CARIBBEAN HEALTH CARE SISTEM
SAN JUAN PR
00921-3201
US

IV. Provider business mailing address

URB APONTE A17 8ST
CAYEY PR
00736
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-738-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number018233
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: