Healthcare Provider Details

I. General information

NPI: 1043344237
Provider Name (Legal Business Name): RUBEN A RUBERO APONTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRION MADURO ST. #51-C
COAMO PR
00769
US

IV. Provider business mailing address

PO BOX 454
COAMO PR
00769-0454
US

V. Phone/Fax

Practice location:
  • Phone: 787-803-0040
  • Fax: 787-803-0070
Mailing address:
  • Phone: 787-376-2063
  • Fax: 787-803-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number15717
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: