Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 13586 | PR |
NPI | 1245224278 |
---|---|
Provider Name | Dr. Pedro J Tort-Saade |
First Address | San Juan, PR 00926-6013 |
Second Address | Guaynabo, PR 00969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 02/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13586 | MEDICAL LICENSE (01) | PR |