Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 12934 | PR |
NPI | 1023050986 |
---|---|
Provider Name | Dr. Ana Vidal |
First Address | San Juan, PR 00926-5320 |
Second Address | San Juan, PR 00926-5321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |