Provider Demographics
NPI:1639245251
Name:PIMENTEL, ANICIA
Entity Type:Individual
Prefix:DR
First Name:ANICIA
Middle Name:
Last Name:PIMENTEL
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:PO BOX 4143
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4143
Mailing Address - Country:US
Mailing Address - Phone:787-640-7940
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO CEM
Practice Address - Street 2:PONCE DE LEON #1409
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00914
Practice Address - Country:US
Practice Address - Phone:787-960-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4166207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology