Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 44 | PR |
NPI | 1063406205 |
---|---|
Provider Name | Dr. Jose A. Mattei |
First Address | Arecibo, PR 00614-0272 |
Second Address | Arecibo, PR 00612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 24/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U19928 | (02) |