Provider Demographics
NPI:1619050911
Name:PIETRI, MARIA MILAGROS (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MILAGROS
Last Name:PIETRI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1677 CALLE LILAS
Mailing Address - Street 2:URB. SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6351
Mailing Address - Country:US
Mailing Address - Phone:787-787-5151
Mailing Address - Fax:787-787-7979
Practice Address - Street 1:100 AVE LAUREL
Practice Address - Street 2:URB. SANTA JUANITA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4816
Practice Address - Country:US
Practice Address - Phone:787-787-5151
Practice Address - Fax:787-787-7979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
PR8133204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD95887Medicare UPIN