Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 6312 | PR |
NPI | 1114916905 |
---|---|
Provider Name | Dr. Jaime Osvaldo Rodriguez-Arias |
First Address | Ponce, PR 00716-2303 |
Second Address | Ponce, PR 00716-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 20/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C-84166 | (02) |