Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 17,885 | PR |
NPI | 1205030988 |
---|---|
Provider Name | Jorge J. Zequeira Diaz |
First Address | San Juan, PR 00926-6314 |
Second Address | San Juan, PR 00935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 30/01/2020 |