Basic Information
| Provider Information | |||||||||
| NPI: | 1669496873 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPOS | ||||||||
| FirstName: | MARIBEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70344 | ||||||||
| Address2: | PMB #65 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009368344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773225 | ||||||||
| FaxNumber: | 7877585307 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF PEDIATRICS 1A-29 | ||||||||
| Address2: | UNIVERSITY PEDIATRIC HOSPITAL | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877564010 | ||||||||
| FaxNumber: | 7877773227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 13254 | PR | Y | Other Service Providers | Specialist |
No ID Information.