Provider Demographics
NPI:1245424902
Name:DRA YAZMIN MOJICA-ARROYO, CSP
Entity Type:Organization
Organization Name:DRA YAZMIN MOJICA-ARROYO, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAZMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJICA-ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-382-9070
Mailing Address - Street 1:URB PALACIOS DEL PRADO
Mailing Address - Street 2:CALLE PACIFICO L 147
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-382-9070
Mailing Address - Fax:
Practice Address - Street 1:URB PALACIOS DEL PRADO
Practice Address - Street 2:CALLE PACIFICO L 147
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-382-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13804302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR200147OtherMMM
PR1780OtherAMERICAN HEALTH MEDICARE
PR2973OtherPREFERRED MEDICARE CHOICE
PR7950029OtherHUMANA DE PR
PR84038 MOOtherTRIPLE S INC
PR1780OtherAMERICAN HEALTH MEDICARE
PRH75260Medicare UPIN