Healthcare Provider Details

I. General information

NPI: 1932337755
Provider Name (Legal Business Name): MARIANGELIX ARIZMENDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE GUADALUPE FINAL # 184
PONCE PUERTO RICO
00733
UM

IV. Provider business mailing address

VISTA MAR CALLE 1 B-6
GUAYAMA PR
00784
US

V. Phone/Fax

Practice location:
  • Phone: 787-709-4130
  • Fax: 787-709-4134
Mailing address:
  • Phone: 787-557-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1103
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: