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General NPI Number Information
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NPI Number | 1205812492
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Entity Type | Individual
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Provider Name | NORMA A DEVARIE MD
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 138 AVE WINSTON CHURCHILL BOX 844
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City | SAN JUAN
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State | PR
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Zip | 00926-6013
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Country | US
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Telephone | 787-765-8977
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Fax | 787-282-6059
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Provider Business Mailing Address
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Address Line | 1002 CALLE 44 SE REPARTO METROLITANO
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City | SAN JUAN
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State | PR
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Zip | 00921-2719
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Country | US
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Telephone | 787-765-8977
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Fax | 787-282-6059
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 8302
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License Number State | PR
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