1508971128 NPI number — MR. RUBEN RODRIGUEZ-PEREZ SR. MD

Table of content: MR. RUBEN RODRIGUEZ-PEREZ SR. MD (NPI 1508971128)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508971128 NPI number — MR. RUBEN RODRIGUEZ-PEREZ SR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ-PEREZ
Provider First Name:
RUBEN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508971128
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O BOX 361080
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-783-7097
Provider Business Mailing Address Fax Number:
787-783-7097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 21 #1785
Provider Second Line Business Practice Location Address:
HOSPITAL METROPOLITANO OFFICE 104 LAS LOMAS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-1981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-782-9999
Provider Business Practice Location Address Fax Number:
787-783-7097
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  5816 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com