Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 2014025382 | MO |
Y | 213ER0200X | Radiology | 2014025382 | MO |
NPI | 1508381534 |
---|---|
Provider Name | Dr. Federico Esteban Villafane |
First Address | Bayamon, PR 00958-0723 |
Second Address | Bayamon, PR 00956-4644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2017 |
Last Update Date | 10/08/2017 |