Healthcare Provider Details

I. General information

NPI: 1114992948
Provider Name (Legal Business Name): CHARLES EDWARD ZIERENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ORTOPEDIA RCM PISO 9 SUITE 595 CENTRO MEDICO DE PR, BO. MONACILLOS
RIO PIEDRAS PR
00935
US

IV. Provider business mailing address

PO BOX 29134 DEPARTAMENTO DE ORTOPEDIA RCM
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-5095
  • Fax: 787-620-0714
Mailing address:
  • Phone: 787-764-6095
  • Fax: 787-620-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number8561
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: