Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 2034 | PR |
NPI | 1083671630 |
---|---|
Provider Name | Johana Ortiz Aponte |
First Address | Carolina, PR 00988-8761 |
Second Address | Carolina, PR 00988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 14/07/2012 |