Healthcare Provider Details

I. General information

NPI: 1760346787
Provider Name (Legal Business Name): YARITZA CASANOVA MANGUAL HEALTH EDUCATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 AVE ROLANDO CABANAS
UTUADO PR
00641-2494
US

IV. Provider business mailing address

PO BOX 1151
UTUADO PR
00641-1151
US

V. Phone/Fax

Practice location:
  • Phone: 787-698-0073
  • Fax:
Mailing address:
  • Phone: 787-698-0073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number4172420
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: