Basic Information
| Provider Information | |||||||||
| NPI: | 1528306982 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADORNO BONILLA | ||||||||
| FirstName: | DAMARIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5347 AVE ISLA VERDE | ||||||||
| Address2: | APT 1005 COND MARBELLA OESTE | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009795543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875143803 | ||||||||
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| Practice Location | |||||||||
| Address1: | AVE COMERIO # 167 | ||||||||
| Address2: | |||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009614477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877404000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2013 | ||||||||
| LastUpdateDate: | 01/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | 7415 | PR | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.