Provider Demographics
NPI:1518201383
Name:MORA MIELES, CLAUDIA IVELISSE (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:IVELISSE
Last Name:MORA MIELES
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:COLINAS DE VILLA TOLEDO
Mailing Address - Street 2:448 CALLE URUTI
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-447-5384
Mailing Address - Fax:
Practice Address - Street 1:COLINAS DE VILLA TOLEDO
Practice Address - Street 2:448 CALLE URUTI
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-447-5384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20223208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice