Individual
DEYANEIRA RAICES DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 AVE HOSTOS STE 118, PONCE, PR 00716-1119
(787) 841-3260
Mailing address
HC 1 BOX 5005, CAMUY, PR 00627-9194
(787) 475-4410
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2876
PR
Other
Enumeration date
09/25/2023
Last updated
10/15/2023
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