Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 14100 | PR |
NPI | 1023091188 |
---|---|
Provider Name | Leonel Enrique Guerrero Rodriguez |
First Address | Caguas, PR 00725 |
Second Address | Fajardo, PR 00738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 20/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I-34813 | (02) | PR |