MARA LEE MEDINA (NPI# 1447865530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447865530 |
| Entity Type | Individual |
| Full Name | MARA LEE MEDINA |
| Practice Address |
15 Calle Doctor Basora Mayaguez PR 00681 |
| Mailing Address |
Po Box 387 San Antonio PR 00690-0387 |
| Practice Telephone | 7878340101 |
| Mailing Telephone | 7879752520 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 021964 | PR | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 21964 | PR | Allopathic & Osteopathic Physicians |
| Street Address |
15 CALLE DOCTOR BASORA |
| City | MAYAGUEZ |
| State | PR |
| Zip Code | 00681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790342491 | Freddie Irizarry-delgado | Student in an Organized Health Care Education/Training Program | 15 Calle Doctor Basora, Mayaguez, PR 00681 | 2019-05-29 |
| 1851924674 | Carlos Omar Nesbeth | General Practice | 15 Calle Doctor Basora, Mayaguez, PR 00680 | 2020-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841826385 | Iocp Optical LLC | Optometrist | Edificio 101 Mendez Vigo, Mayaguez, PR 00681 | 2020-03-17 |
| 1295365674 | Yaniel A Garcia Cortes | Pharmacist | Carr#2 Puerto Rico, Mayaguez, 00681, Mayaguez, PR 00681 | 2020-01-24 |
| 1922647007 | Melissa Ramirez-gonzalez | Pharmacy | Carr 352 Km 4.6 Bo Leguisamo, Mayaguez, PR 00681 | 2020-01-06 |
| 1942849849 | Joshua Rafael Gonzalez Echevarria | Nurse Anesthetist, Certified Registered | Calle Doctor Barbosa # 15, Mayaguez, PR 00681 | 2019-12-26 |
| 1619516432 | Melodie Katherine Padilla Santiago | Psychologist | Calle Ramon Emeterio Betances, #392, Mayaguez, Pr, PR 00681 | 2019-12-26 |
| 1831757350 | Juan Cristian Perez Olmos | Family Medicine | 410 Carretera 2 Ave Hostos, Bo Sabalos, Mayaguez, PR 00681 | 2019-05-30 |
| 1720553514 | Optical Supercenter Arecibo Corp. | Optometrist | 4 Calle Zafiro, Vista Verde, Mayaguez, PR 00681 | 2018-10-08 |
| 1194215756 | Manuel Morillo Menendez | Family Medicine | 410 Ave Hostos Carr 2, Bo Sabalos, Mayaguez, PR 00681 | 2018-05-18 |
| 1972017325 | Pedro L. Cortes Jr. | Psychologist | Professional Building Plaza, Avenida Hostos 770 Suite 302, Mayaguez, PR 00681 | 2017-11-21 |
| 1700324092 | Psicodrama Pr Cp | Clinic/Center | Carr 2 Km 156.5, 510 Ave Hostos Vista Verde Plaza Suite A-12a, Mayaguez, PR 00681 | 2017-02-07 |
| Find all providers in zip 00681 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334522 | Aixa Ramirez Fonseca | General Practice | 4030 Villa Ramirez, Mayaguez, PR 00682-6100 | 2020-10-19 |
| 1417555970 | Ninoshka Velez Perez | General Practice | 2 Res Mayaguez Gdns, Mayaguez, PR 00680-1857 | 2020-10-15 |
| 1396358479 | Meddyg Group LLC | General Practice | 7 Calle Ramon Emeterio Betnaces, Esquina De Diego, Mayaguez, PR 00680 | 2020-08-28 |
| 1780295212 | Julian Alejandro Rosado | General Practice | 55 Calle Manuel M Samas, Mayaguez, PR 00682-5856 | 2020-08-10 |
| 1255957908 | Alexander Enrique Benitez Rodriguez | General Practice | Carr. 106 Km. 13.8 Bo. Naranjales, Mayaguez, PR 00680 | 2020-06-18 |
| 1346874518 | Angel Joel Ortiz | General Practice | 269 Calle Diego Colon, Mayaguez, PR 00682-6037 | 2020-02-26 |
| 1053967638 | Francin Jean Baptiste | General Practice | 15 Calle Dr. Basora, Mayaguez, PR 00680 | 2019-08-10 |
| 1952956765 | Medicina Preventiva Del Oeste | General Practice | 60 N Post Center Office 207, Calle Ramon E Betances, Mayaguez, PR 00682-7634 | 2019-08-08 |
| 1326502543 | Ronald Gonzalez | General Practice | 114 Calle La Candelaria, Mayaguez, PR 00680 | 2019-01-23 |
| 1366911471 | Jorge Manuel Gomez | General Practice | Calle Emeterio Betances #56 Norte, Mayaguez, PR 00680 | 2018-11-19 |
| Find all providers in MAYAGUEZ | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.