Provider Demographics
NPI:1063619393
Name:ARNAL, MIREYA (PT)
Entity type:Individual
Prefix:MRS
First Name:MIREYA
Middle Name:
Last Name:ARNAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 CALLE REINA DE LAS FLORES
Mailing Address - Street 2:HACIENDA REAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-9787
Mailing Address - Country:US
Mailing Address - Phone:939-645-7887
Mailing Address - Fax:
Practice Address - Street 1:CARR 857 KM 0.4
Practice Address - Street 2:BO. CANOVANILLA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:939-645-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6606789291OtherMCS