Healthcare Provider Details

I. General information

NPI: 1205281904
Provider Name (Legal Business Name): RRSM PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2016
Last Update Date: 04/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 AVE ASHFORD CLINICAS PM&R
SAN JUAN PR
00907-1511
US

IV. Provider business mailing address

PO BOX 12213
SAN JUAN PR
00914-0213
US

V. Phone/Fax

Practice location:
  • Phone: 787-439-5326
  • Fax:
Mailing address:
  • Phone: 787-439-5326
  • Fax: 787-854-1452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICARDO A RIEFKOHL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-439-5326