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General NPI Number Information
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NPI Number | 1568589265
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Entity Type | Individual
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Provider Name | MARITZA L ESTABIL M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | PENUELAS MEDICAL BUILDING CARRETERA 385 KM 05 OFFICE 105
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-836-5465
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Fax | 787-836-5465
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Provider Business Mailing Address
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Address Line | URBANIZACION STELLA A65 CALLE LIRIO
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City | GUAYANILLA
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State | PR
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Zip | 00656-1909
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Country | US
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Telephone | 787-835-1665
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Fax | 787-836-5465
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14015
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License Number State | PR
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