Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 18757 | PR |
NPI | 1003125022 |
---|---|
Provider Name | Dr. Sara Ivelisse Montalvo Medina |
First Address | Ponce, PR 00728-2676 |
Second Address | Ponce, PR 00728-2676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2010 |
Last Update Date | 01/08/2014 |