Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 16309 | PR |
NPI | 1023162799 |
---|---|
Provider Name | Dr. Isamarie Montalvo |
First Address | Juncos, PR 00777-1804 |
Second Address | Juncos, PR 00777-3542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 06/04/2020 |