Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 4323 | PR |
NPI | 1063463180 |
---|---|
Provider Name | Mr. Joaquin A Laboy Torres |
First Address | Coto Laurel, PR 00780-1027 |
Second Address | Ponce, PR 00732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C78128 | (02) |