# MAYRA VILLANUEVA PAGAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013392778
- **Authorized official:** MRS. MAYRA EDNA VILLANUEVA (CLINIC SOCIAL WORKER)
- **Authorized official phone:** (787) 689-0665

## Contact information

- **Practice address:** HC 56 BOX 47773, AGUADA, PR 00602-8706
- **Practice address phone:** (787) 689-0665
- **Mailing address:** HC 56 BOX 47773, AGUADA, PR 00602-8706
- **Mailing address phone:** (787) 689-0665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 10647 | PR | Yes |

## Other

- **Enumeration date:** 07/23/2015
- **Last updated:** 07/23/2015