Healthcare Provider Details

I. General information

NPI: 1912518598
Provider Name (Legal Business Name): YARIANA FELICIANO CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2020
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CALLE SAN JOSE E
CAMUY PR
00627-2643
US

IV. Provider business mailing address

7 CALLE SAN JOSE E
CAMUY PR
00627-2643
US

V. Phone/Fax

Practice location:
  • Phone: 787-567-9543
  • Fax:
Mailing address:
  • Phone: 787-567-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number20070010
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: