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General NPI Number Information
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NPI Number | 1396206686
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Entity Type | Organization
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Legal Business Name | IDELVAIS M PINERO MELENDEZ OBSTETRICS & GYNECOLOGY PSC
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 1051 3 SE ST LA RIVIERA MEDICAL CENTER PLAZA 8
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City | SAN JUAN
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State | PR
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Zip | 00929
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Country | US
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Telephone | 939-969-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 144 CALLE TURQUESA
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City | GUAYNABO
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State | PR
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Zip | 00968-3418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IDELVAIS M PINERO
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Credential | MD
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Telephone | 939-969-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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