Provider Demographics
NPI:1780890483
Name:ROCED INC
Entity type:Organization
Organization Name:ROCED INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CEDENO TERRADES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-287-5119
Mailing Address - Street 1:35 JUAN CARLOS BORBON
Mailing Address - Street 2:PMB186 STE67
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5375
Mailing Address - Country:US
Mailing Address - Phone:787-287-5119
Mailing Address - Fax:787-287-5119
Practice Address - Street 1:74 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-287-5119
Practice Address - Fax:787-287-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR112665261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81470Medicare ID - Type UnspecifiedMEDICARE PROVIDER GROUP N