Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 7979 | PR |
NPI | 1306813530 |
---|---|
Provider Name | Dr. Francisco Jose Carlos |
First Address | San Juan, PR 00917-5022 |
Second Address | San Juan, PR 00917-5022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E10157 | (02) | PR |