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General NPI Number Information
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NPI Number | 1649546136
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Entity Type | Organization
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Legal Business Name | ST GIANNA PEDIATRICS
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 312 AVE DE DIEGO SUITE 606
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City | SAN JUAN
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State | PR
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Zip | 00909-1756
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Country | US
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Telephone | 787-375-9090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41234
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City | SAN JUAN
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State | PR
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Zip | 00940-1234
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Country | US
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Telephone | 787-375-9090
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Fax |
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Authorized Official
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Title or Position | PRESIDENTA
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Name | DR. OLGA M LLITERAS
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Credential | MD
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Telephone | 787-375-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | PR
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