Provider Demographics
NPI:1174372890
Name:PICO BARRETO, MELBA DAINA
Entity type:Individual
Prefix:
First Name:MELBA
Middle Name:DAINA
Last Name:PICO BARRETO
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:HC 2 BOX 12124
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-8262
Mailing Address - Country:US
Mailing Address - Phone:939-202-9036
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 12124
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-8262
Practice Address - Country:US
Practice Address - Phone:939-202-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program