Dr. Carmen Luisa Mediavilla, M.D.
Clinic/Center, Medically Fragile Infants and Children Day Care in Hato Rey, PR. Individual provider (NPI-1).
NPI number1407050776
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1407050776
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carmen Luisa Mediavilla
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM3000X | Clinic/Center, Medically Fragile Infants and Children Day Care | 004984 | PR | Yes |
Practice location
400 Ave. F.D. Roosevelt,clinica Las Americas Suite 203
Hato Rey, PR 00918
Phone 787-783-4423 · Fax 787-781-5342
Mailing address
400 Ave. F.D. Roosevelt,clinica Las Americas Suite 203
Hato Rey, PR 00918
Phone 787-783-4423 · Fax 787-781-5342
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