Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 11632 | PR |
NPI | 1508874876 |
---|---|
Provider Name | Dr. Jose I Almodovar - Laborde |
First Address | San German, PR 00683-9340 |
Second Address | San German, PR 00683-9340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 29/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82864 | (02) | PR |