Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 7673 | PR |
NPI | 1295847374 |
---|---|
Provider Name | Julio Simons |
First Address | Hato Rey, PR 00919 |
Second Address | Hato Rey, PR 00919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 15/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7673 | (02) | |
D08800 | (02) | PR |