Provider Demographics
NPI:1144215245
Name:RG HEMATOLOGY ONCOLOGY PSC
Entity Type:Organization
Organization Name:RG HEMATOLOGY ONCOLOGY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GARCIA ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-249-2244
Mailing Address - Street 1:1353 CARR 19
Mailing Address - Street 2:GARDEN HILLS PLAZA PMB 386
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-249-2244
Mailing Address - Fax:787-726-7447
Practice Address - Street 1:CALLE MANUEL PAVIA FERNANDEZ 655
Practice Address - Street 2:EDIFICIO CHINEA 4TO PISO
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-728-2479
Practice Address - Fax:787-726-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14280207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14280Medicare ID - Type Unspecified