Individual
WILSON ROVIRA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 CALLE DE DIEGO E, MAYAGUEZ, PR 00680-4863
(787) 652-4205
(787) 652-4206
Mailing address
PO BOX 601, MAYAGUEZ, PR 00681-0601
(787) 652-4205
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
21095
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/21/2011
Last updated
10/10/2018
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