Basic Information
| Provider Information | |||||||||
| NPI: | 1972799591 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASASNOVAS | ||||||||
| FirstName: | CAMILLE | ||||||||
| MiddleName: | NANETTE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | COND JARD METRO II APT 2M | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877631196 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | AMERICO MIRANDA AVE. | ||||||||
| Address2: | PEDIATRIC UNIVERSITY DISTRICT HOSPITAL | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2007 | ||||||||
| LastUpdateDate: | 08/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 17978 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.