Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 8708 | PR |
N | 207YP0228X | Pediatric Otolaryngology | 8708 | PR |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 8708 | PR |
NPI | 1619902582 |
---|---|
Provider Name | Pedro J Rullan Marin |
First Address | San Juan, PR 00917-5022 |
Second Address | San Juan, PR 00917-5022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/11/2010 |