Healthcare Provider Details

I. General information

NPI: 1023021573
Provider Name (Legal Business Name): ETHEL C LAMELA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CALLE BARBOSA
ISABELA PR
00662-2956
US

IV. Provider business mailing address

PO BOX 2546
ISABELA PR
00662-9546
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-5090
  • Fax: 787-872-5090
Mailing address:
  • Phone: 787-872-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7847
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: