Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 4102 | PR |
NPI | 1013971712 |
---|---|
Provider Name | Mr. William Feliciano |
First Address | Toa Alta, PR 00953-4867 |
Second Address | Bayamon, PR 00959-7200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 22/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063458 | BLUE CROSS (01) | PR |
24829FE | TRIPLE-S (01) | PR |
3404102 | U.I.A. (01) | PR |
6200091 | HUMANA HEALTH PLAN (01) | PR |
6200091 | HUMANA INS. (01) | PR |
6745 | FIRST MEDICAL (01) | PR |
825623 | MMM (01) | PR |
C79395 | (02) | PR |