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General NPI Number Information
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NPI Number | 1811969959
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Entity Type | Individual
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Provider Name | YOSANNA SEGARRA VALLEJO MD
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Gender | Female
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | CALLE JUPITER #30-2
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City | CAROLINA
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State | PR
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Zip | 00979-4841
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Country | US
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Telephone | 787-268-0221
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Fax | 787-268-0221
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Provider Business Mailing Address
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Address Line | PO BOX 79111
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City | CAROLINA
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State | PR
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Zip | 00984
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Country | US
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Telephone | 787-662-2251
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Fax | 787-268-0221
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14404
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License Number State | PR
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