Individual
WANDA IVELISSE QUILES
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
TORRE SAN CRISTOBAL, SUITE 309, COTO LAUREL, PR 00780
(787) 813-2089
Mailing address
TORRE SAN CRISTOBAL, SUITE 309, COTO LAUREL, PR 00780
(787) 813-2089
(787) 840-8821
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
12745
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89939
SSS
PR
01
—
M061418
CRUZ AZUL
PR
Enumeration date
04/27/2006
Last updated
07/08/2007
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