Healthcare Provider Details

I. General information

NPI: 1285984385
Provider Name (Legal Business Name): RA MD SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2012
Last Update Date: 09/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CALLE RAFAEL ALGARIN URB VALENCIA I
JUNCOS PR
00777-3730
US

IV. Provider business mailing address

PO BOX 3504
JUNCOS PR
00777-6504
US

V. Phone/Fax

Practice location:
  • Phone: 787-207-7900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE ORLANDO RIVERA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-207-7900