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Individual

DR. MARIO LUIS OLIVENCIA MALAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
55 CALLE DE DIEGO E STE 401, MAYAGUEZ, PR 00680-5081
(787) 487-7866
Mailing address
CPR PROFESIONAL BUILDING 65 DE DIEGO E.SUITE STE. 401, MAYAGUEZ, PR 00680-8501
(787) 805-1032

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20164
PR

Other

Enumeration date
11/05/2012
Last updated
07/18/2017
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