Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 15439 | PR |
NPI | 1013113802 |
---|---|
Provider Name | Dr. Norman Javier De La Rosa |
First Address | Guaynabo, PR 00968-3123 |
Second Address | Guaynabo, PR 00966-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 04/08/2010 |