Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 5445 | PR |
NPI | 1043201866 |
---|---|
Provider Name | Abelardo I Vargas-Morales |
First Address | Carolina, PR 00986-0059 |
Second Address | Carolina, PR 00628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2005 |
Last Update Date | 03/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C77461 | (02) | PR |