Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 12268 | PR |
N | 2081S0010X | Sports Medicine | 12268 | PR |
N | 213ES0000X | Sports Medicine | 12268 | PR |
NPI | 1033247218 |
---|---|
Provider Name | Dr. Luis N Olmedo |
First Address | San Juan, PR 00926 |
Second Address | San Juan, PR 00926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |