Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 3396 | PR |
NPI | 1245208891 |
---|---|
Provider Name | Leonardo Torres-Rodriguez |
First Address | Bayamon, PR 00960 |
Second Address | Bayamon, PR 00960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 28/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C8344 | (02) | PR |