Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 3897 | PR |
N | 2080P0214X | Pediatric Pulmonologist | 3897 | PR |
NPI | 1518105477 |
---|---|
Provider Name | Pedro L. Valle-Rodriguez |
First Address | Mayaguez, PR 00680-3186 |
Second Address | Mayaguez, PR 00680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 30/01/2009 |