Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15080 | PR |
NPI | 1033310693 |
---|---|
Provider Name | Dr. Luis Manuel Sanchez |
First Address | Hatillo, PR 00659 |
Second Address | Arecibo, PR 00612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I24789 | (02) |