Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 12422 | PR |
NPI | 1346382413 |
---|---|
Provider Name | Hector A Garcia Marrero |
First Address | Vega Baja, PR 00693 |
Second Address | Bayamon, PR 00959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12422 | LICENSE (01) | PR |