Healthcare Provider Details

I. General information

NPI: 1922872415
Provider Name (Legal Business Name): ADRIANA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND WHITE TOWER SE
SAN JUAN PR
00921-3062
US

IV. Provider business mailing address

PO BOX 967
AGUADA PR
00602-0967
US

V. Phone/Fax

Practice location:
  • Phone: 787-366-6094
  • Fax:
Mailing address:
  • Phone: 787-366-6094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number6626202
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: