Provider Demographics
NPI:1942331731
Name:VIZCARRONDO, MAYRA Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:Y
Last Name:VIZCARRONDO
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:PEDIATRIA GENERAL RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-756-4010
Mailing Address - Fax:787-777-3227
Practice Address - Street 1:CENTRO MEDICO DE PR BO MONACILLOS
Practice Address - Street 2:DEPARTAMENTO DE PEDIATRIA, OFICINA 1 A-29
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-756-4020
Practice Address - Fax:787-777-3227
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2016-10-11
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Provider Licenses
StateLicense IDTaxonomies
PR11243208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics