Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 12571 | PR |
NPI | 1053365155 |
---|---|
Provider Name | Miss Jeannette Morales |
First Address | San Juan, PR 00926 |
Second Address | San Juan, PR 00926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89195 | SSS (01) | PR |