Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 12550 | PR |
NPI | 1013010032 |
---|---|
Provider Name | Dr. Wilfredo Adorno |
First Address | Cayey, PR 00737 |
Second Address | Cayey, PR 00737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 21/02/2014 |