Provider Demographics
NPI:1336888585
Name:PENA, NORA HILDA
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:HILDA
Last Name:PENA
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 7793
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7793
Mailing Address - Country:US
Mailing Address - Phone:787-584-5884
Mailing Address - Fax:
Practice Address - Street 1:700 CALLE DR MANUEL F PAVIA
Practice Address - Street 2:ESQ FERNANDEZ JUNCOS SUITE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-496-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty