Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 8129 | PR |
NPI | 1033373030 |
---|---|
Provider Name | Mrs. Myriam Lizett Perez-Padilla |
First Address | Arecibo, PR 00614 |
Second Address | Arecibo, PR 00612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 18/07/2008 |