Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 0280 | PR |
N | 2251N0400X | Physical Therapist - Neurology | 0280 | PR |
N | 2251X0800X | Physical Therapist - Orthopedic | 0280 | PR |
NPI | 1326037763 |
---|---|
Provider Name | Mrs. Mirna L Flores Santiago |
First Address | Carolina, PR 00984-3022 |
Second Address | Rio Piedras, PR 00983 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 08/07/2007 |