Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 4262 | PR |
NPI | 1043234941 |
---|---|
Provider Name | Dr. Reinaldo Rosario Guardiola |
First Address | San Juan, PR 00918-4257 |
Second Address | San Juan, PR 00918-4257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E08241 | (02) | PR |