Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5845 | PR |
NPI | 1013999655 |
---|---|
Provider Name | Edgar Baucage Garcia |
First Address | Aguadilla, PR 00605-1298 |
Second Address | Moca, PR 00678-0068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 23/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D08423 | (02) | PR |