Healthcare Provider Details

I. General information

NPI: 1801807367
Provider Name (Legal Business Name): HECTOR LUIS ROUBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RIEKCHOL #99
PATILLAS PR
00723
US

IV. Provider business mailing address

PO BOX 1510
GUAYAMA PR
00785-1510
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-4351
  • Fax: 787-271-0004
Mailing address:
  • Phone: 787-866-4073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number8269
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: