Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 340 | PR |
NPI | 1154656692 |
---|---|
Provider Name | Mr. Hector M. Barreto |
First Address | Caguas, PR 00727-5918 |
Second Address | Caguas, PR 00727-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2009 |
Last Update Date | 15/10/2009 |