Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 16194 | PR |
NPI | 1013950948 |
---|---|
Provider Name | Dr. Huascar A Barros Burgos |
First Address | San Juan, PR 00907-3181 |
Second Address | Trujillo Alto, PR 00976-5933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16194 | LICENSE (01) | PR |