Organization
RENALIFE, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENDA MICHELLE MIRANDA TIRADO (PRESIDENT)
(787) 224-0499
Entity
Organization
Contact information
Practice address
HOSPITAL AUXILIO MUTUO, AVE PONCE DE LEON PDA 37 1/2, SAN JUAN, PR 00919
(787) 458-2000
Mailing address
PO BOX 1947, CAGUAS, PR 00726-1947
(787) 224-0499
(787) 687-7639
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
17265
PR
Other
Enumeration date
09/14/2012
Last updated
06/25/2020
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