Healthcare Provider Details
I. General information
NPI: 1235366303
Provider Name (Legal Business Name): RRQ UROLOGY INSTITUTE PCS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2009
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BAYAMON MEDICAL MALL SUITE 908
BAYAMON PR
00959-7200
US
IV. Provider business mailing address
BAYAMON MEDICAL MALL SUITE 908
BAYAMON PR
00959-7200
US
V. Phone/Fax
- Phone: 787-798-7751
- Fax: 787-780-6370
- Phone: 787-798-7751
- Fax: 787-780-6370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RAFAEL
RUIZ-QUIJANO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-798-7751