Provider Demographics
NPI:1902245590
Name:ZAYAS, TANIA C (MD)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:C
Last Name:ZAYAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:C
Other - Last Name:ZAYAS - TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 260177
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2618
Mailing Address - Country:US
Mailing Address - Phone:787-768-1315
Mailing Address - Fax:787-995-7043
Practice Address - Street 1:DL13 AVE FIDALGO DIAZ VIA EMILIA
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-768-1355
Practice Address - Fax:787-995-7043
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR188752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty