Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 8973 | PR |
NPI | 1104802180 |
---|---|
Provider Name | Dr. Juan Luis Salgado |
First Address | San Juan, PR 00910 |
Second Address | San Juan, PR 00909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E65769 | (02) |