Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 12027 | PR |
NPI | 1417161159 |
---|---|
Provider Name | Dr. Maria Del Mar Machado |
First Address | Carolina, PR 00979-5300 |
Second Address | Bayamon, PR 00956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
87987 | SSS (01) | PR |