Healthcare Provider Details

I. General information

NPI: 1316878291
Provider Name (Legal Business Name): MRS. KELYMAR ARZUAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SANTA CRUZ URB #70
BAYAMON PR
00956
US

IV. Provider business mailing address

PO BOX 654
CIDRA PR
00739-0654
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-4747
  • Fax:
Mailing address:
  • Phone: 787-620-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number83204
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: