Provider Demographics
NPI:1245547587
Name:MAYMI, ANGELES D
Entity type:Individual
Prefix:
First Name:ANGELES
Middle Name:D
Last Name:MAYMI
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 1:629 CALLE PLUTON
Mailing Address - Street 2:VISTAS DE MONTE SOL
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4174
Mailing Address - Country:US
Mailing Address - Phone:787-365-7327
Mailing Address - Fax:787-267-4941
Practice Address - Street 1:629 CALLE PLUTON
Practice Address - Street 2:VISTAS DE MONTE SOL
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4174
Practice Address - Country:US
Practice Address - Phone:787-365-7327
Practice Address - Fax:787-267-4941
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1143026347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle