Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 11904 | PR |
Y | 207RH0003X | Hematology & Oncology | 11904 | PR |
NPI | 1437263936 |
---|---|
Provider Name | Dr. Amarilys Mangual |
First Address | Ponce, PR 00730 |
Second Address | Yauco, PR 00698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 31/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41218 | (02) | PR |