Provider Demographics
NPI:1043553100
Name:GRACIA, MARIA DEL C (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL C
Last Name:GRACIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BARRIO YAUREL HC 1 BOX 5970
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714
Mailing Address - Country:UM
Mailing Address - Phone:787-839-8736
Mailing Address - Fax:787-271-0004
Practice Address - Street 1:99 GUILLERMO RIEFKHOL STREET
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-0000
Practice Address - Country:US
Practice Address - Phone:787-839-4320
Practice Address - Fax:787-271-0004
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21117163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse