Provider Demographics
NPI:1770284473
Name:MEJIAS-FEBRES, ELLIS D
Entity type:Individual
Prefix:MR
First Name:ELLIS
Middle Name:D
Last Name:MEJIAS-FEBRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7063 CARR 187 COND PLAYA SERENA
Mailing Address - Street 2:APT 403
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-340-0993
Mailing Address - Fax:
Practice Address - Street 1:7063 CARR 187 COND PLAYA SERENA
Practice Address - Street 2:APT 403
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-340-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program