Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 13795 | PR |
N | 2080P0204X | Pediatric Emergency Doctor | 13795 | PR |
NPI | 1245267814 |
---|---|
Provider Name | Dr. Maria Isabel Gomez |
First Address | Gurabo, PR 00778 |
Second Address | Caguas, PR 00725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 13/01/2011 |