Provider Demographics
NPI:1801807367
Name:ROUBERT, HECTOR LUIS (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:LUIS
Last Name:ROUBERT
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:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1510
Mailing Address - Country:US
Mailing Address - Phone:787-866-4073
Mailing Address - Fax:
Practice Address - Street 1:RIEKCHOL #99
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-4351
Practice Address - Fax:787-271-0004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
PR8269208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center