Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 8241 | PR |
NPI | 1407854060 |
---|---|
Provider Name | Dr. Jenaro Scarano-Garcia |
First Address | Coto Laurel, PR 00780-1058 |
Second Address | Ponce, PR 00717-1515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 12/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3102 | INT MED CARD PROVIDER (01) | PR |
7320016 | HUMANA PROVIDER (01) | PR |
99647 | TRIPLE S PROVIDER (01) | PR |
D08806 | (02) | PR |