Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 2801 | PR |
NPI | 1154408862 |
---|---|
Provider Name | Hiram Sosa Miranda |
First Address | Guayama, PR 00785-1018 |
Second Address | Guayama, PR 00784-4905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 02/09/2016 |