Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 16978 | PR |
NPI | 1023213154 |
---|---|
Provider Name | Dr. Andres Emanuelli Anzalotta |
First Address | Arecibo, PR 00613-2770 |
Second Address | Arecibo, PR 00612-4368 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 03/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16978 | LICENCIA MD (01) | PR |