Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 68989 | GA |
N | 111NI0900X | Internist | 68989 | GA |
Y | 207RI0200X | Infectious Disease | 68989 | GA |
NPI | 1033422753 |
---|---|
Provider Name | Valeria Daniela Cantos Lucio |
First Address | Atlanta, GA 30303-3033 |
Second Address | Atlanta, GA 30303-3033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2010 |
Last Update Date | 09/08/2017 |