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NPI Code Detail

MEDICARE: DR. HAROLD NELSON STODDARD LATORRE M.D.

MEDICARE:  DR. HAROLD NELSON STODDARD LATORRE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician12024PR
2174400000XSpecialistPR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112024OTHERPRMEDICAL LICENSE

General Provider Information

NPI Number : 1689646408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAROLD NELSON STODDARD LATORRE M.D.
Provider Business Mailing Address
First Line : PO BOX 19536
Second Line :
City : SAN JUAN
State : PR
Zip : 00910-1536
Country : US
Telephone Number : 787-977-0707
Fax Number : 787-977-0708
Provider Business Practice Location Address
First Line : 1519 AVE PONCE DE LEON
Second Line : SUITE 1105
City : SAN JUAN
State : PUERTO RICO
Zip : 00910
Country : AX
Telephone Number : 787-977-0707
Fax Number : 787-977-0708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 12/14/2016

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Directions to “ DR. HAROLD NELSON STODDARD LATORRE M.D.” Practice Location

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