Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 11305 | PR |
N | 207QA0505X | Family Doctor - Adult Medicine | 11305 | PR |
NPI | 1316930027 |
---|---|
Provider Name | Dr. Luis Santos Perez-Toro |
First Address | Bayamon, PR 00961-6910 |
Second Address | Bayamon, PR 00961-6910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 20/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67888 | (02) | PR |