Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 19610 | PR |
NPI | 1033469390 |
---|---|
Provider Name | Dr. Edgar Hernandez Montalvo |
First Address | Manati, PR 00674 |
Second Address | Manati, PR 00674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 28/11/2017 |