Healthcare Provider Details

I. General information

NPI: 1467923276
Provider Name (Legal Business Name): ZULEIKA MONTANEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 AVENIDA JUAN PONCE DE LEON
SAN JUAN PR
00912
US

IV. Provider business mailing address

BO. SUMIDERO SECTOR LAS TORRES KM 3.5
AGUAS BUENAS PR
00703
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-0773
  • Fax:
Mailing address:
  • Phone: 939-269-1716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number86653
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: