Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 16505 | PR |
NPI | 1053427443 |
---|---|
Provider Name | Dr. Gilberto A Solivan Acosta |
First Address | San Juan, PR 00926-4217 |
Second Address | San Juan, PR 00926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |