Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 1832 | PA |
NPI | 1003897331 |
---|---|
Provider Name | Dr. David Latoni-Cabanillas |
First Address | Mayaguez, PR 00681-1856 |
Second Address | Mayaguez, PR 00680-4949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C82622 | (02) |