| Doctor Name: | KATIUSKA NIKOLE BAEZ |
| NPI Number: | 1578952339 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 13830-I |
| Business Practice Address: | Carr. #188 Int. #187 Concilio De Salud Integral De Loiza Loiza, PR - 00772 |
| Business Phone Number: | 7878762042 |
| Business Fax Number: | 7878767416 |
| Mailing Address: | Torre Cibeles Ii, Apt 522. SAN JUAN |
| State: | PR |
| Postal Code: | 009183995 |
| Phone Number: | 7873938400 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2015 |
| NPI Last Update Date: | 07/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13830-I |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |