Provider Demographics
NPI:1063732303
Name:FELICIANO-GONZALEZ, ZYLKA J (MT)
Entity type:Individual
Prefix:MRS
First Name:ZYLKA
Middle Name:J
Last Name:FELICIANO-GONZALEZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1593
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-1593
Mailing Address - Country:US
Mailing Address - Phone:787-223-5199
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 435 KM 0.1 BARRIO CALABAZAS
Practice Address - Street 2:BARRIO CALABAZAS
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-223-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6990246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other