Provider Demographics
NPI:1447687223
Name:TRAVERZO, LUISA (RN, BSN)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:TRAVERZO
Suffix:
Gender:F
Credentials:RN, BSN
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 1061
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1061
Mailing Address - Country:US
Mailing Address - Phone:787-466-1937
Mailing Address - Fax:
Practice Address - Street 1:C 23 CALLE AYMACO
Practice Address - Street 2:URB PARQUE LAS HACIENDAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-1061
Practice Address - Country:US
Practice Address - Phone:787-466-1937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4674343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)