Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 5002 | PR |
NPI | 1033101217 |
---|---|
Provider Name | Francisco Berio Ramos |
First Address | Corozal, PR 00783 |
Second Address | Corozal, PR 00783 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 25/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTH000 | (02) |