Provider Demographics
NPI:1528037306
Name:OTERO, RUBEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:L
Last Name:OTERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:CALLE RIO CANAS D-15 APT 2
Mailing Address - Street 2:RIO HONDO 1
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-528-7689
Mailing Address - Fax:787-787-9082
Practice Address - Street 1:E22 CALLE SANTA CRUZ
Practice Address - Street 2:OFICINA 208
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6905
Practice Address - Country:US
Practice Address - Phone:787-740-4286
Practice Address - Fax:787-787-9082
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR8225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023781Medicare ID - Type Unspecified
PRA64229Medicare UPIN