Provider Demographics
NPI:1972303139
Name:MATTEI DE JESUS, YOZAIRA (PA)
Entity type:Individual
Prefix:
First Name:YOZAIRA
Middle Name:
Last Name:MATTEI DE JESUS
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE. ROBERRTO CLEMENTE ,
Mailing Address - Street 2:URB. VILLA CAROLINA, 124-8
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00981-0000
Mailing Address - Country:US
Mailing Address - Phone:787-257-0709
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA CAROLINA,
Practice Address - Street 2:#124-8 AVE. ROBERRTO CLEMENTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00981-0000
Practice Address - Country:US
Practice Address - Phone:787-257-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR844363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical