Provider Demographics
NPI:1801893946
Name:RUBAYO GARCIA, DIANA (DMD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:RUBAYO GARCIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALDERON DE LA BARCA W4-7, HUCARES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6807
Mailing Address - Country:US
Mailing Address - Phone:787-293-6158
Mailing Address - Fax:787-294-1454
Practice Address - Street 1:PONCE DE LEON 735, TORRE MEDICA AUXILIO MUTUO
Practice Address - Street 2:SUITE 713
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5030
Practice Address - Country:US
Practice Address - Phone:787-753-0185
Practice Address - Fax:787-294-1454
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice