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Individual

MARILEE ALEJANDRA TIRU VEGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4TA EXT EL MONTE, CORDOVA ST C82, PONCE, PR 00730
(787) 407-0059
Mailing address
PO BOX 801426, COTO LAUREL, PR 00780-1426
(787) 407-0059

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
36166
PR
390200000X
Student in an Organized Health Care Education/Training Program
6411627
PR

Other

Enumeration date
02/05/2020
Last updated
09/21/2022
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