Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 8813 | PR |
NPI | 1063463586 |
---|---|
Provider Name | Jorge L. Santana - Bagur |
First Address | San Juan, PR 00910-0957 |
Second Address | Manati, PR 00674-0674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 28/02/2012 |