Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 017193 | PR |
NPI | 1033375522 |
---|---|
Provider Name | Dr. Mildred Aileen Diaz-Sola |
First Address | Toa Baja, PR 00950-1431 |
Second Address | Toa Baja, PR 00949-3312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 04/11/2015 |