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 | 208600000X | Surgery | | 4610 | 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 | 660574003 | OTHER | | MCS CLASSICARE |
| 2 | PE2111 | OTHER | | PAN AMERICAN LIFE |
| 3 | D08323 | MEDICARE UPIN | | |
| 4 | 660374003 | OTHER | | SERI BELLA LDH |
| 5 | 660574003 | OTHER | | AETNA |
| 6 | 660574003 | OTHER | | MEDICAL CARD REFORMA |
| 7 | 660574003 | OTHER | | MMM HEALTHCARE |
| 8 | 20895 | OTHER | | AMPR |
| 9 | 06530 | OTHER | | BLUE CARD |
| 10 | 660574003 | OTHER | | COSVIMED |
| 11 | 06530 | OTHER | | CRUZ ARU |
| 12 | 660574003 | OTHER | | TRICARE |
| 13 | 3134 | OTHER | | AMERICAN HEALTH |
| 14 | 660574003 | OTHER | | CIGNA |
| 15 | 660574003 | OTHER | | GHI |
| 16 | 346771 | OTHER | | MEDICAL CARD SYSTEM |
| 17 | 5165 | OTHER | | INTERNATIONAL MEDICAL CAR |
| 18 | 660574003 | OTHER | | FIRST PLUS MEDICARE |
| 19 | 660574003 | OTHER | | HUMANA MILITARY |
| 20 | 0087917 | MEDICARE ID-TYPE UNSPECIFIED | | |
