Healthcare Provider Details

I. General information

NPI: 1780878629
Provider Name (Legal Business Name): MIRELY FIGUEROA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 CALLE HUELVA VALLE DE ANDALUCIA
PONCE PR
00728-3109
US

IV. Provider business mailing address

3011 CALLE HUELVA VALLE DE ANDALUCIA
PONCE PR
00728-3109
US

V. Phone/Fax

Practice location:
  • Phone: 787-259-5593
  • Fax:
Mailing address:
  • Phone: 787-259-5593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17768
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: