Healthcare Provider Details

I. General information

NPI: 1841798659
Provider Name (Legal Business Name): CARMEN MILAGROS SILVA BAEZ MSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARKETPLACE CLL 2 YABUCOA 00767
YABUCOA PR
00767
US

IV. Provider business mailing address

MARKETPLACE CLL 2 YABUCOA 00767
YABUCOA PR
00767
US

V. Phone/Fax

Practice location:
  • Phone: 787-376-7141
  • Fax:
Mailing address:
  • Phone: 787-376-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number81513
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: