Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 6541 | PR |
NPI | 1831129279 |
---|---|
Provider Name | Dr. Juan Ovidio Perez-Rodriguez |
First Address | San Juan, PR 00913 |
Second Address | San Juan, PR 00919-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 27/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D26719 | (02) |