Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18754 | PR |
N | 111NI0900X | Internist | 18754 | PR |
Y | 207SG0201X | Clinical Genetics (M.D.) | 35335 | OK |
N | 207SG0201X | Clinical Genetics (M.D.) | DR.0056958 | CO |
N | 207SG0201X | Clinical Genetics (M.D.) | ME129070 | FL |
NPI | 1770900904 |
---|---|
Provider Name | Dr. Yazmin Enchautegui Colon |
First Address | Oklahoma City, OK 73104-5036 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 15/12/2021 |