Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 05727 | PR |
NPI | 1487840302 |
---|---|
Provider Name | Dr. Pedro Federico Berdeguer-De Leon |
First Address | Minneola, FL 34755-1097 |
Second Address | San Juan, PR 00921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 25/09/2007 |