Provider Demographics
NPI:1821850504
Name:PALMERO CAPOTE, MAYELIN
Entity Type:Individual
Prefix:
First Name:MAYELIN
Middle Name:
Last Name:PALMERO CAPOTE
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 1:8356 THOR ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-9253
Mailing Address - Country:US
Mailing Address - Phone:904-790-2579
Mailing Address - Fax:
Practice Address - Street 1:709 MALL BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4881
Practice Address - Country:US
Practice Address - Phone:904-790-2579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program