Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 21768 | PR |
N | 207X00000X | Orthopaedic Surgeon | 282723 | MA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 21768 | PR |
NPI | 1144635319 |
---|---|
Provider Name | Samuel Fernandez-Perez |
First Address | Bayamon, PR 00961-6933 |
Second Address | Bayamon, PR 00961-6933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 13/09/2021 |