Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 10980 | PR |
NPI | 1003856774 |
---|---|
Provider Name | Dr. Jorge L Robles |
First Address | Guayama, PR 00785-2998 |
Second Address | Guayama, PR 00784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 23/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10980 | STATE LICENCE (01) | PR |
G41092 | (02) | PR |