Mediavilla, Carmen Luisa

Mediavilla, Carmen Luisa is an sole proprietor health care provider with primary practice located at 400 Ave. F.D. Roosevelt ,Clinica Las Americas Suite 203, Hato Rey PR 00918. She recently has only one registered license in Ambulatory Health Care Facilities / Medically Fragile Infants and Children Day Care, which is considered as her primary health care specialty. Mediavilla, Carmen Luisa can be contacted via phone (787) 783-4423.

Contact Information

Primary practice address
400 Ave. F.D. Roosevelt ,Clinica Las Americas Suite 203 Hato Rey PR 00918
Fax: (787) 781-5342
Website:

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medically Fragile Infants and Children Day Care 261QM3000X 004984 Puerto Rico

Profile Details

NPI number 1407050776
LBN Legal business name Mediavilla, Carmen Luisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407050776 NPPES
Puerto Rico Other 004984 LICENSE MD,PR
Puerto Rico Other 98980 LICENSE MD,PR

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