Individual
LAURA TERESA DOMENECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
280 CALLE MONTERREY, PONCE, PR 00716-0377
(787) 840-2505
Mailing address
PO BOX 7004, PONCE, PR 00732-7004
(787) 840-2575
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13246
PR
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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