Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 433 | PR |
NPI | 1003883919 |
---|---|
Provider Name | Dr. Amarilys Sandoval Jimenez |
First Address | Camuy, PR 00627-9760 |
Second Address | Quebradillas, PR 00678-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 12/04/2017 |