MEDICARE: NOELIA BAEZ RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1828	PR

General Provider Information

NPI Number	:	1528482379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOELIA BAEZ RN

Provider Business Mailing Address
First Line	:	21 CHRISMAN ROAD
Second Line	:
City	:	FORT BUCHANAN
State	:	PUERTO RICO
Zip	:	00934
Country	:	UM
Telephone Number	:	787-707-2535
Fax Number	:	787-707-2280

Provider Business Practice Location Address
First Line	:	21 CHRISMAN RD
Second Line	:
City	:	FORT BUCHANAN
State	:	PR
Zip	:	00934-4519
Country	:	US
Telephone Number	:	787-504-6683
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2014
Last Update Date	:	02/14/2014

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