Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15152 | PR |
NPI | 1013936939 |
---|---|
Provider Name | Dr. Diana Pilar Gaona |
First Address | Ponce, PR 00717 |
Second Address | Ponce, PR 00717-0712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |