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General NPI Number Information
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NPI Number | 1083863393
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Entity Type | Individual
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Provider Name | JAIMARI AQUERON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 06/03/2011
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Provider Practice Location Address
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Address Line | 202 CALLE CLAUDIO CARRERO BO. MANI
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City | MAYAGUEZ
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State | PR
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Zip | 00682-6178
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Country | US
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Telephone | 787-464-1551
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 596
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City | LAJAS
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State | PR
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Zip | 00667-0596
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Country | US
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Telephone | 787-464-1551
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17296
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License Number State | PR
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