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General NPI Number Information
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NPI Number | 1518671619
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Entity Type | Organization
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Legal Business Name | RODOLFO ESTREMERA MARCIAL LLC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 1801 SANTURCE MEDICAL MALL SUITE 409-410
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City | SAN JUAN
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State | PR
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Zip | 00919
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Country | US
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Telephone | 939-338-0793
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Fax |
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Provider Business Mailing Address
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Address Line | PANORAMA K-5 TERRAZAS DE CARRAIZO
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-0000
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Country | US
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Telephone | 787-233-3131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODOLFO ESTREMERA MARCIAL
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Credential | ME
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Telephone | 939-338-0793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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