Healthcare Provider Details

I. General information

NPI: 1942697727
Provider Name (Legal Business Name): RS GASTROENTEROLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND LA CORUNA CARR 177 APT 2503
GUAYNABO PR
00969
US

IV. Provider business mailing address

COND LA CORUNA CARR 177 APT. 2503
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-7218
  • Fax: 787-761-5764
Mailing address:
  • Phone: 787-884-7218
  • Fax: 787-761-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number17927
License Number StatePR

VIII. Authorized Official

Name: ROBERT B SOJO-ALTIERI
Title or Position: PRESIDENT
Credential: MD
Phone: 787-884-7218