Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 0116032647 | VA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 21809 | PR |
NPI | 1104244508 |
---|---|
Provider Name | Alberto Criado |
First Address | San German, PR 00683-9301 |
Second Address | San German, PR 00683-0068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 05/10/2020 |