Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 14090 | PR |
N | 208000000X | Pediatrician | 14090 | PR |
NPI | 1336108166 |
---|---|
Provider Name | Dr. Gredia M Huerta |
First Address | Guaynabo, PR 00970-3916 |
Second Address | San Juan, PR 00907-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 08/07/2007 |