Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 17082 | PR |
Y | 111NI0900X | Internist | 17082 | PR |
N | 207RG0300X | Geriatric Medicine | 17082 | PR |
N | 207RH0002X | Hospice and Palliative Medicine | 17082 | PR |
NPI | 1275706178 |
---|---|
Provider Name | Dr. Libertad Isabel Ruscalleda Reyes |
First Address | Arecibo, PR 00612 |
Second Address | San Juan, PR 00921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 15/03/2016 |