Provider Demographics
NPI:1508971128
Name:RODRIGUEZ-PEREZ, RUBEN SR (MD)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:RODRIGUEZ-PEREZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 361080
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-783-7097
Mailing Address - Fax:787-783-7097
Practice Address - Street 1:CARR 21 #1785
Practice Address - Street 2:HOSPITAL METROPOLITANO OFFICE 104 LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1981
Practice Address - Country:US
Practice Address - Phone:787-782-9999
Practice Address - Fax:787-783-7097
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5816207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR97342Medicare PIN
PRE-31230Medicare UPIN
E31230Medicare UPIN