Provider Demographics
NPI:1215250147
Name:FELICIANO, ZULMA I (BS,MT,ASCP)
Entity type:Individual
Prefix:MRS
First Name:ZULMA
Middle Name:I
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:BS,MT,ASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 CALLE MUNOZ RIVERA # B
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-3340
Mailing Address - Country:US
Mailing Address - Phone:787-871-4255
Mailing Address - Fax:787-871-4255
Practice Address - Street 1:83 CALLE MUNOZ RIVERA # B
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3340
Practice Address - Country:US
Practice Address - Phone:787-871-4255
Practice Address - Fax:787-871-4255
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2442247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2442OtherLICENCIA TECNOLOGO MEDICO