Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 9461 | PR |
NPI | 1023234028 |
---|---|
Provider Name | Dr. Aileen Carreras |
First Address | San Juan, PR 00927 |
Second Address | San Juan, PR 00927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012665 | HUMANA REFORMA (01) | PR |
4159 | AMERICAN HEALTH MEDICARE (01) | PR |