Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 13939 | PR |
NPI | 1093760894 |
---|---|
Provider Name | Dr. Merida S. Colon Caban |
First Address | Guaynabo, PR 00969 |
Second Address | San Juan, PR 00921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 30/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2190114 | DRIVERS LICENCE (01) | PR |