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 | 207R00000X | Internal Medicine | | 4823 | 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 | 212176 | OTHER | PUERTO RICO | UTI |
| 2 | 4823 | OTHER | PUERTO RICO | IMC PROVIDER ID |
| 3 | 25874 | OTHER | PUERTO RICO | SSS OF PUERTO RICO |
| 4 | 4304823 | OTHER | PUERTO RICO | UIA |
| 5 | 100197 | OTHER | PUERTO RICO | MEDICARE MUCHO MAS ID# |
| 6 | 1661 | OTHER | PUERTO RICO | PEFERRED MEDICARE CHOICE |
| 7 | 063664 | OTHER | PUERTO RICO | CRUZ AZUL DE PUERTO RICO |
| 8 | 29825 | OTHER | PUERTO RICO | AAMPR PROVIDER ID |
| 9 | 4823 | OTHER | PUERTO RICO | COSVI PROVIDER ID |
| 10 | 25874 | OTHER | PUERTO RICO | MEDICARE OPTIMO ID# |
| 11 | 3387 | OTHER | PUERTO RICO | AMERICAN HEALTH PLAN |
| 12 | 6430019 | OTHER | PUERTO RICO | HUMANA PORVIDER ID |
| 13 | E-31089 | MEDICARE UPIN | PUERTO RICO | |
| 14 | 0025874 | MEDICARE ID-TYPE UNSPECIFIED | PUERTO RICO | PROVIDER NUMBER |
