Healthcare Provider Details

I. General information

NPI: 1164411393
Provider Name (Legal Business Name): MILAGROS M SALVA-MARIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LIBUTAD #30
JAYUYA PR
00664
US

IV. Provider business mailing address

PO BOX 306
JAYUYA PUERTO RICO
00664
UM

V. Phone/Fax

Practice location:
  • Phone: 787-828-1184
  • Fax: 787-828-1184
Mailing address:
  • Phone: 787-828-1184
  • Fax: 787-828-1184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6762
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: