Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 0039 | PR |
NPI | 1184705568 |
---|---|
Provider Name | Dr. Egidio Montanile |
First Address | San Juan, PR 00910-1657 |
Second Address | Santurce, PR 00909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T50886 | (02) | PR |