Provider Demographics
NPI:1285884486
Name:SALGUEIRO CANETTI, LISSETTE (MD)
Entity type:Individual
Prefix:
First Name:LISSETTE
Middle Name:
Last Name:SALGUEIRO CANETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISSETTE
Other - Middle Name:
Other - Last Name:SALGUEIRO CANETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1315 ASHFORD AVE APT. 1105
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-961-4655
Mailing Address - Fax:
Practice Address - Street 1:HIMA PLAZA 1 STE 502
Practice Address - Street 2:DEGETAU AVE #500
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7301
Practice Address - Country:US
Practice Address - Phone:787-961-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125208207X00000X
PR17972207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery