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General NPI Number Information
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NPI Number | 1376878967
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Entity Type | Organization
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Legal Business Name | BELLADONNA MEDICAL WELLNESS
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | CARR #2 KM 42 EXPRESO VEGA Y MOROVIS
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-533-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 4253 CARR 2
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City | VEGA BAJA
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State | PR
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Zip | 00693-3619
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Country | US
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Telephone | 787-533-7520
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. EVELYN CINTRON-PAGAN
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Credential | MD
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Telephone | 787-533-7520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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