Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 10042 | PR |
NPI | 1033101068 |
---|---|
Provider Name | Mr. Jose A Marques Bibiloni SR. |
First Address | San Juan, PR 00910-1798 |
Second Address | Santurce, PR 00909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G40291 | (02) |