Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 386 | PR |
NPI | 1275640856 |
---|---|
Provider Name | Dr. Fernando Miguel Herrera Batista |
First Address | San Juan, PR 00921-4814 |
Second Address | San Juan, PR 00921-4814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 05/11/2019 |