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General NPI Number Information
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NPI Number | 1720492978
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Entity Type | Organization
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Legal Business Name | NRT FAMILY MEDICINE PSC
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | AVENIDA EDUARDO RUBERTE COLISEO SHOPPING CENTER SUITE 103
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City | PONCE
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State | PR
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Zip | 00728-1712
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Country | US
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Telephone | 787-840-9708
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Fax | 787-840-9708
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Provider Business Mailing Address
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Address Line | CALLE MANUEL CHELO ROMAN #48
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City | ADJUNTAS
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State | PR
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Zip | 00601-2217
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Country | US
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Telephone | 787-840-9708
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Fax | 787-840-9708
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Authorized Official
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Title or Position | PRESIDENT
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Name | NITZA RODRIGUEZ
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Credential | MD
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Telephone | 787-840-9708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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