Organization
MB DERMATOLOGY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAYRA C BEAUCHAMP MD (DERMATOLOGIST/OWNER)
(787) 630-1369
Entity
Organization
Contact information
Practice address
CENTRO INTERNACIONAL DE MERCADEO, TOWER 1, SUITE 304, ROAD 165 PR-28, GUAYNABO, PR 00968
(787) 705-8887
(787) 705-8886
Mailing address
PMB 705, 89 DE DIEGO AVE., SUITE 105, SAN JUAN, PR 00927-6320
(787) 705-8887
(787) 705-8886
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
17621
PR
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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