Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 5640 | PR |
NPI | 1154450112 |
---|---|
Provider Name | Mrs. Nilsa M. Vizcarrondo |
First Address | Guayama, PR 00784 |
Second Address | Guayama, PR 00784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |