Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 022043 | PR |
N | 111NI0900X | Internist | 022043 | PR |
Y | 207RH0003X | Hematology & Oncology | 22043 | PR |
NPI | 1043766983 |
---|---|
Provider Name | Karla Jenisse Feliciano Salva |
First Address | San Juan, PR 00936-5067 |
Second Address | Adjuntas, PR 00601-9309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2016 |
Last Update Date | 17/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22043 | MEDICAL LIC (01) | PR |