=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740056951
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | R&R HEALTHCARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2023
-----------------------------------------------------
Last Update Date | 11/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | EV1 CALLE SALVADOR BRAU
-----------------------------------------------------
City | TOA BAJA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00949-2838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-610-5040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | EV1 CALLE SALVADOR BRAU
-----------------------------------------------------
City | TOA BAJA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00949-2838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-610-5040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | GLORIMAR RIVERA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 787-610-5040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------