Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 7710 | PR |
NPI | 1295778991 |
---|---|
Provider Name | Dr. Felix V Matos |
First Address | Caguas, PR 00726-6751 |
Second Address | Carolina, PR 00985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7710 | MEDICAL LICENSE (01) | PR |