Provider Demographics
NPI:1104815083
Name:ALSINA POMALES, ZAMARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ZAMARIE
Middle Name:
Last Name:ALSINA POMALES
Suffix:
Gender:F
Credentials:MD
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 70171
Mailing Address - Street 2:PMB 189
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5014
Practice Address - Country:US
Practice Address - Phone:787-758-6650
Practice Address - Fax:787-294-0317
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11333174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83796Medicare ID - Type Unspecified