Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 22453 | PR |
NPI | 1053089631 |
---|---|
Provider Name | Dr. Alexsandra Rosado Baez |
First Address | San German, PR 00683-0047 |
Second Address | San German, PR 00683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2021 |
Last Update Date | 14/09/2021 |