Provider Demographics
NPI:1396206686
Name:IDELVAIS M PINERO MELENDEZ OBSTETRICS & GYNECOLOGY PSC
Entity Type:Organization
Organization Name:IDELVAIS M PINERO MELENDEZ OBSTETRICS & GYNECOLOGY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IDELVAIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:PINERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-969-0900
Mailing Address - Street 1:144 CALLE TURQUESA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1051 3 SE ST LA RIVIERA
Practice Address - Street 2:MEDICAL CENTER PLAZA 8
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00929
Practice Address - Country:US
Practice Address - Phone:939-969-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty