Provider Demographics
NPI:1043636251
Name:RUEMMELE, VICTOR E (MPSYC)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:E
Last Name:RUEMMELE
Suffix:
Gender:M
Credentials:MPSYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GOLDEN GATE 1 D-G5
Mailing Address - Street 2:BAIROA,
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1147
Mailing Address - Country:US
Mailing Address - Phone:787-310-2092
Mailing Address - Fax:
Practice Address - Street 1:B14 AVE. LOS VETERANOS,
Practice Address - Street 2:URB. VILLA ROSA #3
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-484-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5586103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist