Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 12245 | PR |
NPI | 1043299043 |
---|---|
Provider Name | Felix Miguel Odiott-Sanchez |
First Address | Anasco, PR 00610-0224 |
Second Address | Anasco, PR 00610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 21/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G45362 | (02) |