Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 6637 | PR |
NPI | 1023006756 |
---|---|
Provider Name | Carlos Daniel Garcia |
First Address | San Juan, PR 00919-1338 |
Second Address | San Juan, PR 00925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C79694 | (02) | PR |