Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 1956 | PR |
NPI | 1083874283 |
---|---|
Provider Name | Dr. Georgina M Marroig |
First Address | Guaynabo, PR 00966-3127 |
Second Address | Guaynabo, PR 00966-3127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 11/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02246-7 | DM # (01) | PR |
1956 | LICENSE (01) | PR |
AM5516818 | DEA (01) | PR |