Healthcare Provider Details

I. General information

NPI: 1013185297
Provider Name (Legal Business Name): RAUL MARIO LLINAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SALUD ATU ALCANCE BO. QUEBRADA LARGA ST # 2 KM 142.2
ANASCO PR
00610
US

IV. Provider business mailing address

PO BOX 2093
ANASCO PR
00610-2093
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6767
  • Fax: 787-826-7900
Mailing address:
  • Phone: 787-669-0024
  • Fax: 787-826-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number17527
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: