MEDICARE: MRS. MAYRA L ZAYAS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	554	PR

General Provider Information

NPI Number	:	1992892749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAYRA L ZAYAS P.T.

Provider Business Mailing Address
First Line	:	E2 STREET 4
Second Line	:	URB HACIENDAS DE CARRAIZO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0001
Country	:	US
Telephone Number	:	787-516-0771
Fax Number	:

Provider Business Practice Location Address
First Line	:	HACIENDAS DE CARRAIZO
Second Line	:	C/4 E-2
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0001
Country	:	US
Telephone Number	:	787-516-0771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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