Provider Demographics
NPI:1992498166
Name:MATOS ROMERO, ALANYS NICOLLE
Entity type:Individual
Prefix:
First Name:ALANYS
Middle Name:NICOLLE
Last Name:MATOS ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALANYS
Other - Middle Name:NICOLLE
Other - Last Name:MATOS ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ALANYS
Mailing Address - Street 1:URB. SANTIAGO CALLE 1 #16 LOIZA P.R. 00772
Mailing Address - Street 2:
Mailing Address - City:LOIZA
Mailing Address - State:PR
Mailing Address - Zip Code:00772
Mailing Address - Country:US
Mailing Address - Phone:787-674-4021
Mailing Address - Fax:
Practice Address - Street 1:URB. SANTIAGO CALLE 1 #16 LOIZA P.R. 00772
Practice Address - Street 2:
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-674-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR68947132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty