Provider Demographics
NPI:1902093750
Name:MEJIA, LAURA C (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:C
Last Name:MEJIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PASEO SAN PABLO
Mailing Address - Street 2:ARTURO CADILLA BUILDING SUITE 401
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7022
Mailing Address - Country:US
Mailing Address - Phone:787-786-7391
Mailing Address - Fax:787-798-0900
Practice Address - Street 1:338 CALLE MENDEZ VIGO
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4908
Practice Address - Country:US
Practice Address - Phone:787-278-1147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR66192080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine