Individual
MR. TEMISTOCLES DISLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1172 AVE DOS PALMAS, LEVITTOWN, PR 00949-4102
(787) 784-6396
(787) 753-3902
Mailing address
1773 CALLE ALCALA, URB. COLLEGE PARK, SAN JUAN, PR 00921-4335
(787) 616-7487
(787) 753-3902
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5519
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5519
STATE LICENSE
PR
Enumeration date
09/29/2006
Last updated
07/08/2007
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