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General NPI Number Information
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NPI Number | 1891900239
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Entity Type | Individual
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Provider Name | CARMEN ANA YEJO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | STREET NUM 21, AVE DE DIEGO STATE INSURANCE FUND (CFSE)
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City | SAN JUAN
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State | PR
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Zip | 00936-5028
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Country | US
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Telephone | 787-782-8250
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4258
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City | CAROLINA
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State | PR
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Zip | 00984-4258
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Country | US
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Telephone | 787-749-8788
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 10496
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License Number State | PR
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