Healthcare Provider Details

I. General information

NPI: 1770161325
Provider Name (Legal Business Name): GRECIA ARROYO OTERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 08/02/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO 9WWH+W38
SAN JUAN PR
00921
US

IV. Provider business mailing address

100 AVE LAUREL
BAYAMON PR
00956-4816
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-0333
  • Fax:
Mailing address:
  • Phone: 787-226-1655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36946
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: