Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 6841 | PR |
NPI | 1164581344 |
---|---|
Provider Name | Juan E Garcia |
First Address | Bayamon, PR 00960-5909 |
Second Address | Toa Baja, PR 00949-5388 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 24/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D08446 | (02) | PR |