Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 18422 | PR |
N | 2080P0204X | Pediatric Emergency Doctor | ME124326 | FL |
NPI | 1083870976 |
---|---|
Provider Name | Dr. Yiraima E. Medina-Blasini |
First Address | Ponce, PR 00733-6810 |
Second Address | Ponce, PR 00733-6810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 03/10/2015 |