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Dr. Carmen Luisa Mediavilla, MD
Medically Fragile Infants and Children Day Care in Hato Rey, N/A
NPI 1407050776

Carmen Luisa Mediavilla is a Medically Fragile Infants and Children Day Care based in Hato Rey, and is specialized in Medically Fragile Infants and Children Day Care. Carmen Luisa Mediavilla practices in Hato Rey, and has the professional credentials of MD. The NPI Number for Carmen Luisa Mediavilla is 1407050776 and holds a License No. 004984 (N/A).

The current practice location address for Carmen Luisa Mediavilla is 400 Ave. F.d. Roosevelt, Hato Rey, and can be reached out via phone at 787-783-4423 and via fax at 787-781-5342. You can also correspond with Carmen Luisa Mediavilla through the mailing address at 400 AVE. F.D. ROOSEVELT, HATO REY, PR - 00918 (mailing address contact number: 787-783-4423).

Location: 400 Ave. F.d. Roosevelt, Hato Rey, , 00918
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Provider Profile Details
NPI Number
1407050776
Provider Name
Carmen Luisa Mediavilla
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
400 Ave. F.d. Roosevelt, Hato Rey, , 00918
Phone Number
787-783-4423
Fax Number
787-781-5342
Provider Enumeration Date
06/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004984 01 PR LICENSE MD,PR
98980 01 PR PROVIDER #TRIPLE-S MANAGE
institution
Provider Business Practice Location Address Details
Address
400 Ave. F.d. Roosevelt
City
State
Zip
00918
Phone Number
787-783-4423
Fax Number
787-781-5342
person
Provider Business Mailing Address Details
Address
400 Ave. F.d. Roosevelt
City
State
Zip
00918
Phone Number
787-783-4423
Fax Number
787-781-5342
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medically Fragile Infants and Children Day Care
Taxonomy
License No.
004984 ()
Definition
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.).
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