Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 9477 | PR |
NPI | 1144286055 |
---|---|
Provider Name | Dr. Melvin A Bonilla-Felix |
First Address | San Juan, PR 00926 |
Second Address | Santurce, PR 00912-3207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 17/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31791 | (02) | PR |