Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 16484 | PR |
N | 111NI0900X | Internist | 16484 | PR |
Y | 207RC0000X | Internist - Cardiovascular Disease | 16484 | PR |
NPI | 1013110485 |
---|---|
Provider Name | Elias Bou Prieto |
First Address | Guaynabo, PR 00969-3170 |
Second Address | Guaynabo, PR 00969-4429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 07/06/2019 |