Provider Demographics
NPI:1083374177
Name:CARMONA ARROYO, JESEYRA GLISET
Entity Type:Individual
Prefix:
First Name:JESEYRA
Middle Name:GLISET
Last Name:CARMONA ARROYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LIRIOS CALA 2
Mailing Address - Street 2:423 CALLE SAN LUIS
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-8510
Mailing Address - Country:US
Mailing Address - Phone:787-373-1808
Mailing Address - Fax:
Practice Address - Street 1:URB LIRIOS CALA 2
Practice Address - Street 2:423 CALLE SAN LUIS
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-8510
Practice Address - Country:US
Practice Address - Phone:787-373-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76615367500000X
PR76615367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered