MEDICARE: RG HEMATOLOGY ONCOLOGY PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	14280	PR

General Provider Information

NPI Number	:	1144215245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RG HEMATOLOGY ONCOLOGY PSC

Provider Business Mailing Address
First Line	:	1353 CARR 19
Second Line	:	GARDEN HILLS PLAZA PMB 386
City	:	GUAYNABO
State	:	PR
Zip	:	00966-2715
Country	:	US
Telephone Number	:	787-249-2244
Fax Number	:	787-726-7447

Provider Business Practice Location Address
First Line	:	CALLE MANUEL PAVIA FERNANDEZ 655
Second Line	:	EDIFICIO CHINEA 4TO PISO
City	:	SANTURCE
State	:	PR
Zip	:	00909
Country	:	US
Telephone Number	:	787-728-2479
Fax Number	:	787-726-7447

Authorized Official
Title or Position	:	DOCTORA
Name	:	MRS. REBECCA P GARCIA ORTIZ
Credential	:	MD
Telephone Number	:	787-249-2244

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/22/2020

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