Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 5118 | PR |
NPI | 1023112430 |
---|---|
Provider Name | Dr. Rolando Quinones Recio |
First Address | Santunce, PR 00911 |
Second Address | Santunce, PR 00911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5118 | LICENSE (01) | PR |
A09623427 | NONE (01) | PR |
D99535 | (02) | PR |
DM040170 | NONE (01) | PR |