Provider Demographics
NPI:1366121873
Name:REGUERO MARTINEZ, PAOLA BEATRIZ (MA)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:BEATRIZ
Last Name:REGUERO MARTINEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 CALLE CESAR GONZALEZ APT 711
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3957
Mailing Address - Country:US
Mailing Address - Phone:787-354-1211
Mailing Address - Fax:
Practice Address - Street 1:592 CALLE CESAR GONZALEZ APT 711
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3957
Practice Address - Country:US
Practice Address - Phone:787-354-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty