Provider Demographics
NPI:1518671965
Name:BERMUDEZ VALENTIN, ELISNEL
Entity Type:Individual
Prefix:MS
First Name:ELISNEL
Middle Name:
Last Name:BERMUDEZ VALENTIN
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:HC 8 BOX 24705
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9652
Mailing Address - Country:US
Mailing Address - Phone:787-449-1760
Mailing Address - Fax:
Practice Address - Street 1:76 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3114
Practice Address - Country:US
Practice Address - Phone:787-449-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program