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General NPI Number Information
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NPI Number | 1124798939
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Entity Type | Organization
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Legal Business Name | RULLAN SINUS SURGICAL CENTER LLC
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 512
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City | SAN JUAN
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State | PR
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Zip | 00917-5027
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Country | US
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Telephone | 787-751-1910
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Fax | 787-282-7131
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Provider Business Mailing Address
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Address Line | 735 AVE PONCE DE LEON STE 512
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City | SAN JUAN
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State | PR
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Zip | 00917-5027
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Country | US
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Telephone | 787-751-1910
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Fax | 787-282-7131
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Authorized Official
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Title or Position | PRESIDENT
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Name | BIANCA RULLAN OLIVER
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Credential | MD
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Telephone | 787-501-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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