Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 00338 | PR |
NPI | 1003001736 |
---|---|
Provider Name | Mr. Rolando Delgado |
First Address | Yauco, PR 00698-1135 |
Second Address | Yauco, PR 00698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2007 |
Last Update Date | 06/09/2007 |