Individual
DR. EVELYN TELLADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
BO SABANA HOYOS SEC VILLA LAGUNA 383, ST EUGENIO MARIA DE HOSTOS, VEGA ALTA, PR 00692
(939) 628-5292
Mailing address
HC 83BOX 7333, VEGA ALTA, PR 00692
(939) 628-5292
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00646-PA
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00646-PA
PSICIAN ASSISTANT
PR
Enumeration date
11/06/2020
Last updated
11/12/2020
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