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General NPI Number Information
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NPI Number | 1619085826
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Entity Type | Individual
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Provider Name | CECILIA JOSELINA MIR M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | FD ROOSEVELT AVENUE #1441
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City | SAN JUAN
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State | PR
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Zip | 00920
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Country | US
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Telephone | 787-793-8383
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Fax | 787-774-4839
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Provider Business Mailing Address
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Address Line | 2070 ST. 1 BOX 405 LOS FRAILES GARDENS
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City | GUYNABO
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State | PR
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Zip | 00966-3508
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Country | US
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Telephone | 787-781-3409
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10,164
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License Number State | PR
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