Provider Demographics
NPI:1326096223
Name:GARCIA PENA, ANETTE DEL ROSARIO
Entity Type:Individual
Prefix:DR
First Name:ANETTE
Middle Name:DEL ROSARIO
Last Name:GARCIA PENA
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:PO BOX 10670
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0670
Mailing Address - Country:US
Mailing Address - Phone:787-844-6980
Mailing Address - Fax:787-651-6717
Practice Address - Street 1:CENTRO CARIBE BUILDING
Practice Address - Street 2:2053 PONCE BY PASS, SUITE 202
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1308
Practice Address - Country:US
Practice Address - Phone:787-844-6980
Practice Address - Fax:787-651-6717
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12321208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice