Healthcare Provider Details

I. General information

NPI: 1821701228
Provider Name (Legal Business Name): ANA MEDDIE LLANTIN PUMAREJO CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CALLE FRANCISCO ORTIZ LEBRON
PATILLAS PR
00723-2813
US

IV. Provider business mailing address

PO BOX 1794
GUAYAMA PR
00785-1794
US

V. Phone/Fax

Practice location:
  • Phone: 787-384-8452
  • Fax:
Mailing address:
  • Phone: 787-384-8452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: