Provider Demographics
NPI:1124798939
Name:RULLAN SINUS SURGICAL CENTER LLC
Entity type:Organization
Organization Name:RULLAN SINUS SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:RULLAN OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-501-0002
Mailing Address - Street 1:735 AVE PONCE DE LEON STE 512
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-5027
Mailing Address - Country:US
Mailing Address - Phone:787-751-1910
Mailing Address - Fax:787-282-7131
Practice Address - Street 1:735 AVE PONCE DE LEON STE 512
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5027
Practice Address - Country:US
Practice Address - Phone:787-751-1910
Practice Address - Fax:787-282-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty