Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 8536 | PR |
NPI | 1235101148 |
---|---|
Provider Name | Mrs. Milagros T. Reyes |
First Address | Caguas, PR 00726-8549 |
Second Address | Aguas Buenas, PR 00703-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 14/12/2012 |