Healthcare Provider Details

I. General information

NPI: 1316239296
Provider Name (Legal Business Name): MISS LAUREN MARIE JARAMILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 GUARD RD
AGUADILLA PR
00603-1304
US

IV. Provider business mailing address

260 GUARD RD
AGUADILLA PR
00603-1304
US

V. Phone/Fax

Practice location:
  • Phone: 787-890-8477
  • Fax:
Mailing address:
  • Phone: 787-890-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: