Doctor Name: | JUDITH TERESA PALMER BENGOA |
NPI Number: | 1124075429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 14006 |
Business Practice Address: | Cond. St. Marys Plaza Torre Sur , Apt. 1601 San Juan, PR - 00907 |
Business Phone Number: | 7875300888 |
Business Fax Number: | 7877541059 |
Mailing Address: | Cond St Marys Plaza, Torre Sur Apt. 1601 SAN JUAN |
State: | PR |
Postal Code: | 00907 |
Phone Number: | 7875300888 |
Fax Number: | 7877541059 |
NPI Enumeration Date: | 05/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |