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Individual

SOL S FUENTES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RT

Contact information

Practice address
AVE. DOMENECH #390, SAN JUAN, PR 00936
(787) 764-7328
Mailing address
PO BOX 365067, SAN JUAN, PR 00936-5067
(787) 758-2525
(787) 751-5434

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
2007
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2007
PROFESSIONAL LICENSE
PR
Enumeration date
04/30/2007
Last updated
07/08/2007
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