Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0090 | PR |
NPI | 1871582890 |
---|---|
Provider Name | Efrain Castro Irizarry |
First Address | San German, PR 00683-1114 |
Second Address | San German, PR 00683-4320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U44278 | (02) | PR |