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General NPI Number Information
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NPI Number | 1891736120
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Entity Type | Individual
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Provider Name | ILSA JANICE NAZARIO MD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 156 CALLE BARCELO
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City | BARRANQUITAS
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State | PR
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Zip | 00794-1621
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Country | US
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Telephone | 787-857-2688
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Fax |
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Provider Business Mailing Address
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Address Line | PALACIOS DEL RIO I 436 CALLE CULEBRINAS Q-8
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City | TOA ALTA
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State | PR
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Zip | 00953-5005
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Country | US
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Telephone |
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 14959
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License Number State | PR
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