Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 21759 | PR |
N | 208D00000X | General Practice Physician | 21759 | PR |
NPI | 1043615677 |
---|---|
Provider Name | Erika T Watts Oquendo |
First Address | San Juan, PR 00907-1368 |
Second Address | Caguas, PR 00726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2014 |
Last Update Date | 28/07/2021 |