| Doctor Name: | MIRCIA ALEXANDRA VALLENILLA MARTE |
| NPI Number: | 1487886727 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 17718 |
| Business Practice Address: | Calle Pimentel Y Castro 200 Cdt Rio Grande Rio Grande, PR - 00745 |
| Business Phone Number: | 7877692092 |
| Business Fax Number: | |
| Mailing Address: | Urb. Rolling Hills, Calle San Luis #ee130 CAROLINA |
| State: | PR |
| Postal Code: | 009877035 |
| Phone Number: | 7877692092 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2009 |
| NPI Last Update Date: | 10/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17718 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |