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General NPI Number Information
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NPI Number | 1114077450
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Entity Type | Individual
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Provider Name | MRS. EVELYN BORRERO
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 ST V1 LAGOS DE PLATA LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-784-5475
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Fax | 787-784-5475
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Provider Business Mailing Address
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Address Line | V1 CALLE 19 LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-3200
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Country | US
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Telephone | 787-784-5475
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Fax | 787-784-5475
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1602692
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License Number State | PR
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