Provider Demographics
NPI:1235348103
Name:LAUREANO-GARCIA, NOEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEMI
Middle Name:
Last Name:LAUREANO-GARCIA
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 21
Mailing Address - Street 2:URB PRECIOSA
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:939-285-9727
Mailing Address - Fax:
Practice Address - Street 1:W1 CALLE VERDE LUZ
Practice Address - Street 2:URB PRECIOSA
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0021
Practice Address - Country:US
Practice Address - Phone:939-285-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11284OtherSTATE LICENSE