Healthcare Provider Details

I. General information

NPI: 1215143565
Provider Name (Legal Business Name): SONIA E. VIRELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ANTONIO R. BARCELO #8
TOA ALTA PR
00954-1137
US

IV. Provider business mailing address

PO BOX 1137
TOA ALTA PR
00954-1137
US

V. Phone/Fax

Practice location:
  • Phone: 787-870-7575
  • Fax: 787-870-7575
Mailing address:
  • Phone: 787-870-7575
  • Fax: 787-870-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: