Healthcare Provider Details
I. General information
NPI: 1578373270
Provider Name (Legal Business Name): SAMYRA MARIE CUPELES ALCOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/13/2025
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PR-2 KM 173
SAN GERMAN PR
00683
US
IV. Provider business mailing address
CAR 313 K1 H0 BAJOS INT BALLAJA
CABO ROJO PR
00681
US
V. Phone/Fax
- Phone: 787-892-1860
- Fax:
- Phone: 787-599-2613
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: