Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 7232 | PR |
NPI | 1033387659 |
---|---|
Provider Name | Olga Negron |
First Address | Juncos, PR 00777-0167 |
Second Address | Juncos, PR 00777-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2008 |
Last Update Date | 16/02/2008 |