Individual
DR. ELY DECLET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
STREET TENIENTE CESAR GONSALEZ, 1106, RIO PIEDRAS, PR 00928
(787) 785-3875
Mailing address
STREET PELICANO URB. MANSIONES DEL MAR, MM108, TOA BAJA, PR 00949
(787) 261-3449
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
12351
PR
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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