Mariemma Lissette Domenech, MD
Student in an Organized Health Care Education/Training Program in Ponce, PR. Individual provider (NPI-1).
NPI number1003668096
StatusActive
Last updated in NPPESApr 3, 2024
Details
- NPI
- 1003668096
- Entity type
- Individual (NPI-1)
- Name
- Mariemma Lissette Domenech
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2024
- Certification date
- Apr 3, 2024
- Last updated
- Apr 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
2213 Ponce BypPonce, PR 00717-1310
Phone 787-840-8686
Mailing address
Po Box 250268Aguadilla, PR 00604-0268
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