Basic Information
| Provider Information | |||||||||
| NPI: | 1376127266 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUA | ||||||||
| FirstName: | SHIELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18-15 CALLE 17 | ||||||||
| Address2: | |||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009596503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4049929831 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1462 CALLE PROF. AUGUSTO RODRIGUEZ | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PUERTO RICO | ||||||||
| PostalCode: | 00909 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 7876411616 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2021 | ||||||||
| LastUpdateDate: | 05/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 134953 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.