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Individual
ELAINE ROQUE NAZARIO
Active
Individual
ELAINE ROQUE NAZARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27920
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57-0359174
TAX ID
SC
Enumeration date
03/29/2007
Last updated
01/09/2013
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