Provider Demographics
NPI:1205959905
Name:BANCHS SEDA, RUBEN CARLOS (MD)
Entity type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:CARLOS
Last Name:BANCHS SEDA
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 1:3201 PORTALES DEL MONTE
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-3201
Mailing Address - Country:US
Mailing Address - Phone:787-675-1952
Mailing Address - Fax:
Practice Address - Street 1:3201 PORTALES DEL MONTE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780-2033
Practice Address - Country:US
Practice Address - Phone:787-675-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16508208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16508OtherLICENSE