Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4962 | PR |
NPI | 1073517355 |
---|---|
Provider Name | Dr. Myriam Zahydee Allende-Vigo |
First Address | San Juan, PR 00936-4246 |
Second Address | Humacao, PR 00791-3948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 07/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E31196 | (02) | PR |