Provider Demographics
NPI:1578668943
Name:GODINEAUX MANFREDY, YAMILKA DAMARIS (MD MEDICO GENERALIST)
Entity Type:Individual
Prefix:
First Name:YAMILKA
Middle Name:DAMARIS
Last Name:GODINEAUX MANFREDY
Suffix:
Gender:F
Credentials:MD MEDICO GENERALIST
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HC # 1 BOX 3562
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-9704
Mailing Address - Country:US
Mailing Address - Phone:787-299-8887
Mailing Address - Fax:787-266-0127
Practice Address - Street 1:VISION 2000 COMMERCE PLAZA SUITE301-305
Practice Address - Street 2:PEDRO AFBIZU CAMPOS URB. COSTA AZUL
Practice Address - City:GUAYAMA-
Practice Address - State:PR
Practice Address - Zip Code:00785-1920
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR16136208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice