Provider Demographics
NPI:1083818009
Name:JUSTINIANO GARCIA, HILDAMARI (MD)
Entity Type:Individual
Prefix:
First Name:HILDAMARI
Middle Name:
Last Name:JUSTINIANO GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HILDA
Other - Middle Name:
Other - Last Name:JUSTINIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3047
Mailing Address - Street 2:MARINA STATION
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3047
Mailing Address - Country:US
Mailing Address - Phone:787-806-2222
Mailing Address - Fax:
Practice Address - Street 1:PR -2 KM. 150.2
Practice Address - Street 2:BARRIO ALGARROBOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-806-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15662207N00000X, 207NS0135X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology