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General NPI Number Information
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NPI Number | 1740594266
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Entity Type | Individual
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Provider Name | MISS AMALIA IVELISSE MONROIG
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | AVE. SAN LUIS SUITE 9550
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City | ARECIBO
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State | PR
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Zip | 00613
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Country | US
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Telephone | 787-878-3552
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Fax | 787-879-8633
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Provider Business Mailing Address
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Address Line | COSTAS DEL ATLANTICO DUNA STREET #87
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City | ARECIBO
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State | PR
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Zip | 00612-5483
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Country | US
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Telephone | 787-548-0045
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 17579
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License Number State | PR
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