Healthcare Provider Details

I. General information

NPI: 1548784010
Provider Name (Legal Business Name): ARACHRISTIE OTERO DIAZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 07/21/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANATI MEDICAL CENTER CALLE HERNANDEZ CARRION URBANIZACION ATENAS
MANATI PR
00674
US

IV. Provider business mailing address

MANATI MEDICAL CENTER CALLE HERNANDEZ CARRION URBANIZACION ATENAS
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3700
  • Fax:
Mailing address:
  • Phone: 787-621-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number14413I
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22183
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: