Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 1770 | PR |
NPI | 1265570337 |
---|---|
Provider Name | Dr. Julio Francisco Correa |
First Address | San Juan, PR 00926-3152 |
Second Address | San Juan, PR 00926-3152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |