Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 8515 | PR |
NPI | 1003807389 |
---|---|
Provider Name | Dr. Maria I Carrera Baquero |
First Address | Fajardo, PR 00738-0667 |
Second Address | Fajardo, PR 00738-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E73863 | (02) |