Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 21356 | PR |
NPI | 1003221458 |
---|---|
Provider Name | Dr. Vincent X Rodriguez Bury |
First Address | San Juan, PR 00936-4641 |
Second Address | Carolina, PR 00985-6179 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 29/09/2020 |