Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 06169 | GA |
Y | 207VG0400X | Gynecologist | 17817 | PR |
NPI | 1194985036 |
---|---|
Provider Name | Dr. Luis Angel Flores |
First Address | Mayaguez, PR 00681-4535 |
Second Address | Mayaguez, PR 00680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 12/11/2010 |