Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 14900R | LA |
NPI | 1003838897 |
---|---|
Provider Name | Jose Rodrigo Restrepo |
First Address | New Orleans, LA 70112-1221 |
Second Address | New Orleans, LA 70112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164984 | (05) | LA |
H89425 | (02) |