Provider Demographics
NPI:1336462621
Name:CANCEL MOUNIER, ERIK (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:CANCEL MOUNIER
Suffix:
Gender:M
Credentials:CRNA
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 3573
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3573
Mailing Address - Country:US
Mailing Address - Phone:787-998-4957
Mailing Address - Fax:787-998-4958
Practice Address - Street 1:AVE PONCE DE LEON # 728
Practice Address - Street 2:201
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1000
Practice Address - Country:US
Practice Address - Phone:787-998-4957
Practice Address - Fax:787-998-4958
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1533367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered