Healthcare Provider Details

I. General information

NPI: 1528482379
Provider Name (Legal Business Name): NOELIA BAEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CHRISMAN RD
FORT BUCHANAN PR
00934-4519
US

IV. Provider business mailing address

21 CHRISMAN ROAD
FORT BUCHANAN PUERTO RICO
00934
UM

V. Phone/Fax

Practice location:
  • Phone: 787-504-6683
  • Fax:
Mailing address:
  • Phone: 787-707-2535
  • Fax: 787-707-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1828
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: