Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 15350 | PR |
NPI | 1417935396 |
---|---|
Provider Name | Dr. Idamer Cintron Baerga |
First Address | Patillas, PR 00723-2409 |
Second Address | Arroyo, PR 00714-2350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2006 |
Last Update Date | 08/07/2007 |