Healthcare Provider Details

I. General information

NPI: 1942220116
Provider Name (Legal Business Name): BRENLIZ MERCEDES ROBLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA LAS AMERICAS HOSPITAL DR.PILA
PONCE PR
00731
US

IV. Provider business mailing address

PO BOX 801293
COTO LAUREL PR
00780-1293
US

V. Phone/Fax

Practice location:
  • Phone: 787-848-5600
  • Fax:
Mailing address:
  • Phone: 787-840-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13375
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: