National Provider Identifier Database

CARMEN L MEDIAVILLA, MD – NPI #1407050776
Medically Fragile Infants and Children Day Care

An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.).


Contact Information

CARMEN L MEDIAVILLA, MD
400 AVE. F.D. ROOSEVELT
,CLINICA LAS AMERICAS SUITE 203
HATO REY, PR00918
Phone: 787-783-4423
Fax: 787-781-5342
Website:
Specialty Taxonomy Code
* Medically Fragile Infants and Children Day Care 261QM3000X

* Indicates primary specialty

NPI Profile & details for CARMEN L MEDIAVILLA

NPI Number 1407050776
Credentials MD
Entity Individual
Enumeration date 06/12/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • PR License #: 004984
  • PR Other: 004984 LICENSE MD,PR
  • PR Other: 98980 PROVIDER #TRIPLE-S MANAGE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for CARMEN L MEDIAVILLA, MD

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