Basic Information
| Provider Information | |||||||||
| NPI: | 1215668736 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERSONENI | ||||||||
| FirstName: | MARIETTA | ||||||||
| MiddleName: | ALEJANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CALLE PALMA REAL | ||||||||
| Address2: | |||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009795805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873607580 | ||||||||
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| Practice Location | |||||||||
| Address1: | RIO PIEDRAS MEDICAL CENTER | ||||||||
| Address2: | UNIVERSITY DISTRICT HOSPITAL | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2022 | ||||||||
| LastUpdateDate: | 07/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 1750530572 | PR | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.