Healthcare Provider Details

I. General information

NPI: 1619614633
Provider Name (Legal Business Name): GEISY CLARITZA NUNEZ PIMENTEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C17 CALLE MARGINAL
BAYAMON PR
00961-6706
US

IV. Provider business mailing address

F36 CALLE BELLISIMA
BAYAMON PR
00956-3251
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-1273
  • Fax:
Mailing address:
  • Phone: 939-278-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number970-PA
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: