Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 22195 | PR |
NPI | 1023565488 |
---|---|
Provider Name | Dr. Meredid Sigmar Maldonado- Santiago |
First Address | Utuado, PR 00641 |
Second Address | Utuado, PR 00641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2016 |
Last Update Date | 24/07/2021 |