Provider Demographics
NPI:1164720975
Name:ADVANCED GASTROENTEROLOGY, PSC
Entity Type:Organization
Organization Name:ADVANCED GASTROENTEROLOGY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:M
Authorized Official - Last Name:RULLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-288-6998
Mailing Address - Street 1:68 CALLE SANTA CRUZ
Mailing Address - Street 2:TORRE SAN PABLO SUITE 803B
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7031
Mailing Address - Country:US
Mailing Address - Phone:787-288-6998
Mailing Address - Fax:
Practice Address - Street 1:68 CALLE SANTA CRUZ
Practice Address - Street 2:TORRE SAN PABLO SUITE 803B
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7031
Practice Address - Country:US
Practice Address - Phone:787-288-6998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty