Provider Demographics
NPI:1083863393
Name:AQUERON, JAIMARI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIMARI
Middle Name:
Last Name:AQUERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 596
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0596
Mailing Address - Country:US
Mailing Address - Phone:787-464-1551
Mailing Address - Fax:
Practice Address - Street 1:202 CALLE CLAUDIO CARRERO
Practice Address - Street 2:BO. MANI
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6178
Practice Address - Country:US
Practice Address - Phone:787-464-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17296208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice