Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 17150 | PR |
N | 207PP0204X | Pediatric Emergency Physician | 17150 | PR |
Y | 208D00000X | General Practice Physician | 17150 | PR |
NPI | 1629245519 |
---|---|
Provider Name | Dr. Juan Neftali Aulet |
First Address | Santa Isabel, PR 00757-9600 |
Second Address | Guayama, PR 00784-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2008 |
Last Update Date | 24/05/2011 |