Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15717 | PR |
NPI | 1043344237 |
---|---|
Provider Name | Dr. Ruben A Rubero Aponte |
First Address | Coamo, PR 00769-0454 |
Second Address | Coamo, PR 00769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 30/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I-74122 | (02) | PR |