Healthcare Provider Details

I. General information

NPI: 1801339239
Provider Name (Legal Business Name): MRS. MARIA MEJIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2016
Last Update Date: 12/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 4 BOX 46800 CARR LA PALMA SECTOR EL SEIS
AGUADILLA PR
00603-9834
US

IV. Provider business mailing address

HC04 BOX 46800 CARR LA PALMA SECTOR EL SEIS
AGUADILLA PR - PUERTO RICO
00603
UM

V. Phone/Fax

Practice location:
  • Phone: 939-339-7957
  • Fax:
Mailing address:
  • Phone: 939-339-7957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number077895-G
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: