Provider Demographics
NPI:1184907446
Name:RASB MEDICAL SERVICES PSC
Entity type:Organization
Organization Name:RASB MEDICAL SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTO BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-784-7200
Mailing Address - Street 1:PMB 167 # 425 CARR. 693
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DORADO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00646
Mailing Address - Country:UM
Mailing Address - Phone:787-784-7200
Mailing Address - Fax:787-761-0613
Practice Address - Street 1:AVENIDA BOULEVARD 3626
Practice Address - Street 2:TERCERA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00946
Practice Address - Country:UM
Practice Address - Phone:787-784-7200
Practice Address - Fax:787-761-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13921208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084321Medicare PIN
PRH55735Medicare UPIN