Healthcare Provider Details

I. General information

NPI: 1851367122
Provider Name (Legal Business Name): REYNALDO RODRIGUEZ-LLAUGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 CALLE ING ISMAEL A COLON
SAN JUAN PR
00918-2802
US

IV. Provider business mailing address

PO BOX 193127
SAN JUAN PR
00919-3127
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-7388
  • Fax: 787-998-2023
Mailing address:
  • Phone: 787-754-7388
  • Fax: 787-998-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number14107
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14107
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number14107
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number14107
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: