Provider Demographics
NPI:1891736997
Name:GARCIA RODRIGUEZ, CARLOS RUBEN (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:RUBEN
Last Name:GARCIA RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:EDIF CLINICA LAS AMERICAS OFIC 205
Mailing Address - Street 2:AVE. ROOSEVELT #400
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-765-1919
Mailing Address - Fax:787-763-4049
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:EDIF CLINICA LAS AMERICAS OFIC 205
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-765-1919
Practice Address - Fax:787-763-4049
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2017-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR13628207RC0200X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR23329Medicare ID - Type UnspecifiedNUMERO PROVEEDOR
PRI43949Medicare UPIN