Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 10710 | PR |
NPI | 1003908922 |
---|---|
Provider Name | Dr. Wilma Caro Caro |
First Address | Cabo Rojo, PR 00623-0835 |
Second Address | Cabo Rojo, PR 00623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 01/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41552 | (02) | PR |