Doctor Name: | DR. ERICA LILIANA BOSSANA |
NPI Number: | 1306041702 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 16605 |
Business Practice Address: | Carr #3 Km 12.3 65 Infanteria Ave Carolina, PR - 009190990 |
Business Phone Number: | 7876032411 |
Business Fax Number: | 7872760065 |
Mailing Address: | P O Box 190090, Hato Rey Station SAN JUAN |
State: | PR |
Postal Code: | 009190990 |
Phone Number: | 7876032411 |
Fax Number: | 7872760065 |
NPI Enumeration Date: | 06/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 16605 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |