Mireya M Bolo Diaz, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

18363 Issued in PR

Practice address

Carr. 891, KM. 1.4, Bo. Pueblo
Corozal, PR 00783-2441

Phone

(787) 944-3337

Fax

(787) 699-0039

NPI assigned

Sep 17, 2009

Last updated

Mar 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1821321191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29828",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290828",
            "fax_number": "787-699-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 891, KM. 1.4, BO. PUEBLO",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007832441",
            "telephone_number": "787-944-3337",
            "fax_number": "787-699-0039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Ave Ponce De Leon",
            "address_2": "Hospital Auxilio Mutuo",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009175032",
            "country_code": "US",
            "telephone_number": "787-758-2000 x1391",
            "fax_number": "787-699-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLO DIAZ",
        "first_name": "MIREYA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "18363",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "PR",
            "license": "18363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Natalia Paola Borges Rivera I
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• Neurology with Special Qualifications in Child Neurology Physician in Corozal, PR
• Providers in Corozal, PR by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.