Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 381 | PR |
NPI | 1023022787 |
---|---|
Provider Name | Ms. Carmen N. Figueroa |
First Address | Mercedita, PR 00715-0312 |
Second Address | Ponce, PR 00716-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |