Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 6188 | PR |
NPI | 1003807298 |
---|---|
Provider Name | Eduardo L Amy Torres |
First Address | Ponce, PR 00732-7402 |
Second Address | Ponce, PR 00717-0791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
069934 | CRYZ AZUL (01) | |
27669 | SSS (01) | |
D08432 | (02) |