Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 6301 | PR |
N | 208000000X | Pediatrician | 6301 | PR |
NPI | 1730164351 |
---|---|
Provider Name | Dr. Milagros B. Martin - Jimenez |
First Address | Rio Piedras, PR 00921 |
Second Address | San Juan, PR 00918-3719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 06/10/2016 |