Provider Demographics
NPI:1497517577
Name:PROSPER, PAOLA M
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:M
Last Name:PROSPER
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:PARAISO DE MAYAGUEZ
Mailing Address - Street 2:CALLE SERENIDAD 193
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:939-639-4661
Mailing Address - Fax:
Practice Address - Street 1:MAYAGUEZ MEDICAL CENTER
Practice Address - Street 2:AVE. HOSTOS #410
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:895-377-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program