Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 12982-I | PR |
N | 111NI0900X | Internist | 12982-I | PR |
N | 207RC0200X | Critical Care Medicine | 18962 | PR |
Y | 207RP1001X | Pulmonary Disease | 18962 | PR |
NPI | 1073897567 |
---|---|
Provider Name | Stella Maris Baez Corujo |
First Address | Caguas, PR 00727-1032 |
Second Address | San Juan, PR 00935-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2011 |
Last Update Date | 25/09/2018 |