Basic Information
Provider Information
NPI: 1407816309
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHATTS
FirstName: PEDRO
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 459
Address2:  
City: MERCEDITA
State: PR
PostalCode: 00715
CountryCode: US
TelephoneNumber: 7872592731
FaxNumber: 7878421951
Practice Location
Address1: GUADALUPE FINAL STREET
Address2:  
City: PONCE
State: PR
PostalCode: 00731
CountryCode: US
TelephoneNumber: 7878404545
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2006
LastUpdateDate: 08/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X11030PRY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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