Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 5347 | PR |
NPI | 1700860566 |
---|---|
Provider Name | Dr. Sonny H Moretta Cabrera |
First Address | Mayaguez, PR 00680 |
Second Address | Mayaguez, PR 00680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 01/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C79619 | (02) | PR |