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General NPI Number Information
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NPI Number | 1144165770
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Entity Type | Organization
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Legal Business Name | PUERTO RICO SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 35 CALLE RUIZ BELVIS
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City | CAGUAS
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State | PR
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Zip | 00725-3784
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Country | US
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Telephone | 787-934-5336
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Fax |
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Provider Business Mailing Address
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Address Line | VIA GUAYABAL 114 URBANIZACION ASOMANTE
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City | CAGUAS
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State | PR
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Zip | 00727-3070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MARTIN E ROLDAN
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Credential | MD
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Telephone | 787-934-5336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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