Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 18835 | PR |
NPI | 1003171398 |
---|---|
Provider Name | Carmen Flecha Melendez |
First Address | Yabucoa, PR 00767 |
Second Address | Yabucoa, PR 00767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 24/07/2015 |