Healthcare Provider Details

I. General information

NPI: 1487807855
Provider Name (Legal Business Name): MRS. TANIA LEYVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CALLE TEODORO AGUILAR URB. LOS MAESTROS
SAN JUAN PR
00923-2435
US

IV. Provider business mailing address

PO BOX 30051
SAN JUAN PR
00929-1051
US

V. Phone/Fax

Practice location:
  • Phone: 787-648-9372
  • Fax:
Mailing address:
  • Phone: 787-648-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: