Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207Q00000X | Family Medicine | | 12332 | PUERTO RICO | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 100649 | OTHER | PUERTO RICO | CRUZ AZUL |
| 2 | 200-365 | OTHER | PUERTO RICO | PREFERRED HEALTH |
| 3 | 3883 | OTHER | PUERTO RICO | PREFERRED MEDICARE CHOICE |
| 4 | 20469 | MEDICARE PIN | PUERTO RICO | |
| 5 | 3612332 | OTHER | PUERTO RICO | UIA |
| 6 | 03827 | OTHER | PUERTO RICO | AMERICAN HEALTH |
| 7 | 716-0040 | OTHER | PUERTO RICO | HUMANA HEALTH PLAN |
| 8 | H30382 | MEDICARE UPIN | PUERTO RICO | |
| 9 | PE-4847 | OTHER | PUERTO RICO | PALIC |
| 10 | 115-12332 | OTHER | PUERTO RICO | GLOBAL HEALTH PLAN |
| 11 | 20469 | OTHER | PUERTO RICO | AUXILIO PLATINO |
| 12 | 20469 | OTHER | PUERTO RICO | TRIPLE SSS |
| 13 | 300115 | OTHER | PUERTO RICO | MMM |
| 14 | 36-0306-7 | OTHER | PUERTO RICO | ACAA |
| 15 | A-040 | OTHER | PUERTO RICO | FIRST MEDICAL/ IMC |
