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General NPI Number Information
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NPI Number | 1528686250
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Entity Type | Individual
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Provider Name | MEIBOL MAS SAN JUAN
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 09/20/2020
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Provider Practice Location Address
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Address Line | 1495 FOREST HILL BLVD STE D
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6073
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Country | US
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Telephone | 561-651-9056
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Fax |
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Provider Business Mailing Address
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Address Line | 54 ABACO DR
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2914
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Country | US
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Telephone | 619-323-5315
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN11007763
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11007763
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License Number State | FL
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