Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 003659 | PR |
NPI | 1003017450 |
---|---|
Provider Name | Gaspar Muniz Rivera |
First Address | Aquadilla, PR 00605-3092 |
Second Address | Aquadilla, PR 00603-9770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 08/07/2007 |