MEDICARE: DR. WANDA MIGDALIA BELTRAN VIRELLA M.D.

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	207R00000X	Internal Medicine Physician	8167	PR

General Provider Information

NPI Number	:	1780687947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WANDA MIGDALIA BELTRAN VIRELLA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 364867
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-4867
Country	:	US
Telephone Number	:	787-787-0310
Fax Number	:	787-798-1275

Provider Business Practice Location Address
First Line	:	SUITE 402 BAYAMON MEDICAL PLAZA
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00956
Country	:	US
Telephone Number	:	787-859-4455
Fax Number	:	787-859-4454

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/07/2019

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