Provider Demographics
NPI:1659590818
Name:ROURA ARIAS, RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:ROURA ARIAS
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 270175
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-2975
Mailing Address - Country:US
Mailing Address - Phone:787-223-1968
Mailing Address - Fax:787-998-0959
Practice Address - Street 1:285 AVE. DOMENECH
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-274-0959
Practice Address - Fax:787-998-5953
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13583207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020278Medicare ID - Type UnspecifiedPROVIDER NUMBER
PR2946OtherPMC PROV. NUMBER
PR7920019OtherHUMANA INS. PROV.NO.
PR0020278Medicare ID - Type UnspecifiedPROVIDER NUMBER
PR061618OtherCRUZ AZUL PROV.NUMBER