Provider Demographics
NPI: | 1871640862 |
---|---|
Name: | DEBS ELIAS, NATALIO (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | NATALIO |
Middle Name: | |
Last Name: | DEBS ELIAS |
Suffix: | |
Gender: | M |
Credentials: | MD |
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 367191 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00936-7191 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-786-4460 |
Mailing Address - Fax: | 787-786-4460 |
Practice Address - Street 1: | 100 PASEO SAN PABLO |
Practice Address - Street 2: | 508 DR. ARTURO CADILLA |
Practice Address - City: | BAYAMON |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00961-7028 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-786-4460 |
Practice Address - Fax: | 787-786-4460 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-01-04 |
Last Update Date: | 2014-07-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | 8165 | 2086S0122X, 2086S0105X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2086S0122X | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery |
No | 2086S0105X | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PR | 0081918 | Medicare ID - Type Unspecified | PROVIDER # |