Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 9894 | PR |
NPI | 1033140975 |
---|---|
Provider Name | Sandra I Aguayo Cedeno |
First Address | Bayamon, PR 00959 |
Second Address | Bayamon, PR 00959-5045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 01/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41293 | (02) |