MEDICARE: ST GIANNA PEDIATRICS

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	208000000X	Pediatrics Physician		PR

General Provider Information

NPI Number	:	1649546136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST GIANNA PEDIATRICS

Provider Business Mailing Address
First Line	:	PO BOX 41234
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00940-1234
Country	:	US
Telephone Number	:	787-375-9090
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 AVE DE DIEGO
Second Line	:	SUITE 606
City	:	SAN JUAN
State	:	PR
Zip	:	00909-1756
Country	:	US
Telephone Number	:	787-375-9090
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTA
Name	:	DR. OLGA M LLITERAS
Credential	:	MD
Telephone Number	:	787-375-9090

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	03/28/2012

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Directions to “ST GIANNA PEDIATRICS ” Practice Location

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