Provider Demographics
NPI:1578636528
Name:MONTEVERDE DOLORIS, ROLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:
Last Name:MONTEVERDE DOLORIS
Suffix:
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:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1305
Mailing Address - Country:US
Mailing Address - Phone:787-347-5444
Mailing Address - Fax:787-831-0052
Practice Address - Street 1:163 CALLE BETANCES
Practice Address - Street 2:BO PARIS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5401
Practice Address - Country:US
Practice Address - Phone:787-347-5444
Practice Address - Fax:787-831-0052
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10872208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9001140OtherCRUZ AZUL
PR2320OtherPMC
PR90449OtherSSS
PR90449OtherMEDICARE OPTIMO
PR90449Medicare ID - Type UnspecifiedMEDICARE
PR9001140OtherCRUZ AZUL