Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 16527 | PR |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 16527 | PR |
N | 208D00000X | General Practice Physician | 16527 | PR |
NPI | 1174646202 |
---|---|
Provider Name | Sabdi Jesse Perez Torres |
First Address | Mayaguez, PR 00680 |
Second Address | Mayaguez, PR 00680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 13/08/2018 |