Healthcare Provider Details

I. General information

NPI: 1184838633
Provider Name (Legal Business Name): ANGEL LUIS ROCAFORT-MARQUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 CAMINO DE LAS LAVANDAS
DORADO PR
00646-6167
US

IV. Provider business mailing address

BAYNE-JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST
FORT POLK LA
71459
US

V. Phone/Fax

Practice location:
  • Phone: 787-215-2300
  • Fax:
Mailing address:
  • Phone: 337-531-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number13397
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: