Healthcare Provider Details

I. General information

NPI: 1770732588
Provider Name (Legal Business Name): MARIA PITRE MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 635 KM 2.4 BO. DOMINGUITO
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 9764 COTTO STATION
ARECIBO PR
00613-9764
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-5324
  • Fax: 787-878-5324
Mailing address:
  • Phone: 787-878-5324
  • Fax: 787-878-5324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number2836
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: