Healthcare Provider Details

I. General information

NPI: 1568639482
Provider Name (Legal Business Name): YAIRAMARIS PELET GIRAUD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HF16 LIZZIE GRANHAM 7MA SECC
TOA BAJA PR
00949
US

IV. Provider business mailing address

URB SABANERA 369 CAMINO DE LAS POMARROSAS
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-795-2935
  • Fax:
Mailing address:
  • Phone: 787-381-7691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17011
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: