Individual
DR. MYRNA ENITH DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
X2 AVE MUNOZ MARIN, CAGUAS, PR 00725-6431
(787) 746-4610
(787) 745-4030
Mailing address
PO BOX 304, GUAYNABO, PR 00970-0304
(787) 746-4610
(787) 745-4030
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
8868
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8868
PR LICENSE
PR
Enumeration date
08/02/2006
Last updated
10/11/2012
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