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General NPI Number Information
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NPI Number | 1669702783
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Entity Type | Individual
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Provider Name | STEPHEN HIGUERA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | C56 CALLE C
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City | GUAYNABO
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State | PR
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Zip | 00969-3288
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Country | US
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Telephone | 787-963-1076
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Fax |
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Provider Business Mailing Address
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Address Line | 35 CALLE JUAN C BORBON STE 67-414
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City | GUAYNABO
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State | PR
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Zip | 00969-5374
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Country | US
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Telephone | 787-963-1076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 17522
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License Number State | PR
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