Most Relevant Information
Provider Data
| NPI Number: | 1003644501 |
| Provider Name: | MIRIAM BATULE DOMINGUEZ CCRP |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/25/2024 |
| Last Updated: | 07/25/2024 |
Provider Practice Location
550 CALLE SERGIO CUEVAS BUSTAMANTE ESQ. AVE DOMENECH
SAN JUAN
PR
00918
Practice Location Phone/Fax
| Phone: | 3055870283 |
| Fax: |
Provider Mailing Location
550 CALLE SERGIO CUEVAS BUSTAMANTE ESQ. AVE DOMENECH
SAN JUAN
PR
00918
Provider Mailing Phone/Fax
| Phone: | 3055870283 |
| Fax: |