Provider Demographics
NPI:1174106959
Name:MERINO MADERA, NOELIA
Entity type:Individual
Prefix:
First Name:NOELIA
Middle Name:
Last Name:MERINO MADERA
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:MONTE CLARO, PASEO DEL MONTE
Mailing Address - Street 2:#MO-2
Mailing Address - City:BAYAMON
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MONTE CLARO, PASEO DEL MONTE
Practice Address - Street 2:#MO-2
Practice Address - City:BAYAMON
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-421-0215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program