Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 15706 | PR |
N | 208D00000X | General Practice Physician | 15706 | PR |
NPI | 1043258098 |
---|---|
Provider Name | Astrid A Carrero Perez |
First Address | Mayaguez, PR 00681-7139 |
Second Address | Mayaguez, PR 00680-1882 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 03/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I-50277 | (02) | PR |