MEDICARE: LIMARI ARCHULETA BRIGNONI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1306596317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIMARI ARCHULETA BRIGNONI

Provider Business Mailing Address
First Line	:	40 CALLE PLANTIO
Second Line	:	URB PASEO DEL PRADO
City	:	CAROLINA
State	:	PR
Zip	:	00987
Country	:	US
Telephone Number	:	787-358-6721
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 CALLE PLANTIO
Second Line	:	URB. PASEO DEL PRADO
City	:	CAROLINA
State	:	PR
Zip	:	00987-0098
Country	:	US
Telephone Number	:	787-358-6721
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	04/07/2022

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